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~_ <br />~~~ ~ <br />ANNUAL FEE and RE ORT REQUEST <br />PERMITTEE NAME: 'Trans Colorado Concrete a Division of Pete Lien & Sons, Inc. <br />PERMIT NO.: ~iVI-2004-013 <br />OPERATION NAME: St. Barbara Sand and Gravel Mine <br />ANNIVERSARY DATE: Apri15, 2008 Oiyo ~~y® <br />~'~~ ,< . ~~008 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) `o~ng`'°~°t'ee~ <br />COUNTY: Pueblo aotdsa~ ryr`~n <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 dates foi• the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual resort and annual report map to this form The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, resort, and associated <br />map. If no new disturbances or reclamation have occurred durin the previous year and no new changes to <br />the previous year's map are necessary, then no new man 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: Joel Brannan <br />Permittee Name: Trans Colorado Concrete a Division of Pete Lien & Sons, Inc. <br />Address: 3401 Universal Ur. <br />P.O. Box 440 <br />Rapid City, SD 57709 <br />Phone Number: (605) 342-7224 <br />Fax Number: (605) 342-6979 <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 />T e lr.ji:T S~ <br />Si ture of Corporate Officer, Owner, or Designee <br />~//~y <br />Date <br />