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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~~ ~ R~ <br />ANNUAL FEE and REPORT RE VEST <br />Leone Sand and Gravel LLC <br />M-2006-085 / <br />Leone Gravel Pit #2 <br />Apri125, 2008 <br /> <br />APR 0 7 2008 <br />Division of declamation, u~ <br />Mining and Safety <br />$$791.00 (Due on or before your anniversary date) <br />Las Animas <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 />_ Y_shall submit the annual feel 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 upcoming year, reclamation that will be performed during the coming year, the dates for~the beginning - <br />ofactive 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 />man. If no new disturbances or reclamation have occurred durinE the previous year and no new changes to <br />the previous year's map are necessary, then no new map is reauired 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: Frank Leone, Jr <br />Permittee Name: Leone Sand and Gravel LLC <br />Address: 502 S. Walnut St. <br />- - - - Trinidad; CO 81082 " - --._,,.. _ - __ _ <br />Phone Number: (719) 846-4170 <br />Fax Number: (719) 846-0606 <br />7/Q --B~FS' - 4 ~ O S <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 />~~ ~~ <br />Signature of Corporate Officer, Owner, or Designee <br />~- ~- ~ ~ <br />Date <br />~ ~d 85 <br />