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~F~-~~~ <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Ephemeral Resources, LLC ~ pp`,c <br />~~V~e~IG / <br />PERMIT NO.: M-2002-046 ~ V <br />APR 14 2008 <br />OPERATION NAME: D Road Gravel Pit <br />Division of Reclamation, ~y <br />ANNIVERSARY DATE: Apri114, 2008 Mining and Safety ~`"/~y <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <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 accomprislied°to-date-an~d~rirrg thy-preceding-year;-novvzlsturbances_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 durin8 the previous vear and no new chanLes 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: Mark Gardner <br />Permittee Name: Ephemeral Resources, LLC <br />Address: 1~22~ <br />sj .~ ~ .~~r w~" `J G p J /~ U e . <br />Grand Junction, CO 81501 <br />Phone Number: (970) 242-5370 <br />Fax Number: (970) 245-7716 <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 Corporate O cer, Owner, or Designee <br /> <br />Date <br />