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o1L <br /> <br /> ANNUAL FEE and REPORT REOUEST - <br /> ?t <br />PERMITTEE NAME: and Land, Inc. ?I?UL 2 8 <br /> <br />PERMIT NO.: 2008 <br />1999-006 <br />?ilE6l- M 1beclxnation, <br />OPERATION NAME: Kurtz Resource Recovery & Land Devlpmnt Pr I Mining and Safety <br />ANNIVERSARY DATE: August 4, 2008 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Weld <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 shall <br />submit the annual fee, a report and map showing the extent of current disturbances to affected land, reclamation <br />accomplished to date and during the preceding year, new disturbances that are anticipated to occur during the upcoming <br />year, reclamation that will be performed during the coming year, the dates for the beginning of active operations, and the <br />date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report may to this form. The Annual Report & Fee <br />requirement is not met until we have received the following components: fee, resort, and associated may. If no <br />new disturbances or reclamation have occurred durine the previous year and no new chances to the previous <br />year's may are necessary, then no new may is required, provided that the Operator shall state this in the Annual <br />Report. Please note that an adequately labeled map that clearly delineates and includes the above elements may <br />suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary changes: <br />Permittee Contact: Christopher L. Varna. <br />Permittee Name: Sand Land, Inc. <br />Address: 8120 Gage St. <br />Frederick, CO 80516 <br />Phone Number: (303) 666-6657 <br />Fax Number: (3) 666-6743 <br />If you have additional comments and/or information that should be provided to the Division, please provide it below or <br />attach it to this form alon with your written report and map. Annual Report instructions are enclosed. <br />Lr t.?? w ` <br />Si tune of Corporate Officer, Owner, or Designee <br />24 July 2008 <br />Date