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~~ ~ ~ ~ <br />PERMITTEE NAME: Benson Brothers / <br />PERMIT NO.: M-1977-062 <br />OPERATION NAME: Hallenbeck Pit No 1 <br />ANNIVERSARY DATE: Apri12, 2008 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anni ersary date) <br />COUNTY: Delta <br />Ffi9~~''"'"~~d <br />MAR 2 ~ 2008 ~/ <br />i~iws n no's d Safety n, l~ <br />M 9 <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of cu~Tent disturbances to affected land, <br />- --- - - - -reclamation-accomplished-to date-and dui°ing the-preceding-year; new disturbances that are-anticipated- to occur <br />during the upcoming year, reclamation that will be performed during the co ing year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report marl to this form. The Annual Report <br />& Fee requirement is not met until we have received the following comp nents: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred durin the evious ear and no new than es to <br />the previous year's map are necessary, then no new map is required, pro ided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map lhc~t clearly delineates and includes the <br />above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Ple~se verify and make any necessary <br />changes: <br />I <br />Permittee Contact: Ed Benson _ <br />Permittee Name: Benson Brothers <br />Address: 21240 Austin Rd <br />Austin, CO 81410 <br />Phone Number: <br />Fax Number: <br />(970) 835-3128 <br />(970)835-8567 <br />If you have additional comments and/or information that should be provide <br />below or attach it to this form along with your written report and map. Annual <br />Signature of Corporate Officer, caner, or Designee <br />to the Division, please provide it <br />2eport instructions are enclosed. <br />Date <br />