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n ~ <br />,~ F ~ 2P-r <br />ANNUAL FEE and REPORT REQUEST <br />PERMTTTEE NAME: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />PERMIT NO.: M-1977-022 ~~~~'~~® <br />OPERATION NAME: Pit No 3 <br />ANNIVERSARY DATE: March 28, 2008 MAR 3 1 2008 ~~ <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) Division of Reclamation, <br />Mining and Safety / <br />COUNTY: Delta <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-snap-.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 upcoming year, reclamation that will be performed during the coming 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 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 year's map are necessary, then no new map is required, provided that the Operator 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: Brent Kerr <br />Permittee Name: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />Address: P.O. Box 3609 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4900 <br />Fax Number: (970) 243-5945 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br /> <br />Date <br />