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<br />?,4f <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />l <br />ANNUAL FEE and REPO T REQUEST <br />.-I- Elam Construction, Inc. <br />cAI-2000-030 <br />AGRI-DLD Gravel Pit <br />July 5, 2008 <br />$$791.00 (Due on or before your anniversary date) <br />La Plata <br />Cfr- #VE.D <br />JUL 0 9 2008 <br />Division % rieciamation, <br />? Mining and Safety <br />O/C <br />f c D <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, ne_w_disturbances that-ar-.e--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 man 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 necessarv, 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: Stephen Kaspar <br />Permittee Name: Elam Construction, Inc. <br />Address: 556 Struthers Ave <br />Grand Junction, CO 81501-3826 <br />Phone Number: (970) 242-5370 <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 orporate Office , caner, or Designee <br />7 <br />Date