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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Sandco,Inc. <br />M1987-064 <br />Dalton Land & Cattle <br />August 27, 2007 <br />$791,00 (Due on or before your anniversary date) <br />La Plata <br />0) <br />RED �VED <br />`-�JUL 1 G 2007 <br />Dsion of Reclamation, <br />Mining and Safety <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 current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcomingyear,- reclamation- that - wilt -be-perfonTra dmring-the-coming year-the-dateg-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 map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous vear's man are necessarv, then no new man is required. provided that the Onerator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: David Dillon <br />Permittee Name: <br />Address: <br />Sandco, hie. <br />P.O. Box 4440 <br />Durango, CO 81302 <br />Phone Number: (970) 247 -1303 <br />Fax Number: (970) 382 -9220 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />bel w or attach it this form long with your written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />7- 9-- d <br />Date <br />
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