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~ ~ ~ R~ <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />PERMIT NO.: M-1981-014 ~ ~~~~~~~® <br />OPERATION NAME: Rozman Pit <br />JUN 2 7 2008 ~ <br />ANNNERSARY DATE: June 29, 2008 <br />ANNUAL FEE DUE: $$791.00 ue on or before our anniversa date Division of Reclamation, <br />(D Y r'Y ) Mining and Safety <br />COUNTY: Gunnison <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-upcom#ng-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 />ma 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Pete Siegmund <br />Permittee Name: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />Address: 2273 River Road <br />P.O. Box 3609 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4900 <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 />Signature of Corporate Officer, Owner, or Des_ ignee <br />w.~ ;2 .S', 2 cs ~ ~' <br />at~ <br /> <br />