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4. <br />~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />ANNUAL FEE and REPORT RE~QQUEST <br />Meeker Sand & Gravel, Inc. / <br />M-1979-103 ~/ <br /> <br />APR 0 8 2008 v <br />OPERATION NAME: Amick Pit Division o'r Reclamation, <br />Mining and Safety <br />ANNIVERSARY DATE: Apri18, 2008 <br />AN>`IUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Rio Blanco <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 upcoming year, reclamation that will be performed during the coming year, the dafes 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: Diana K. Watson <br />Permittee Name: Meeker Sand & Gravel, Inc. <br />Address: 3251 RBC #4 <br />P.O. Box 1550 <br />Meeker, CO 81641 <br />Phone Number: (970) 878-3671 <br />Fax Number: <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 />afore of Corp rate Officer, Owner, or Designee <br />~-1-o S <br />Date <br />