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SSS <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />vNUEiL FEE and REPORT R <br />Meeker Sand & Gravel, Inc. <br />M-1976-038 <br />Meeker Pit <br />July 25, 2008 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Rio Blanco <br />III L h ? .? ? . . <br />i,IU'L 2 9 2008 <br />Uieisir,ro o, ,leclammation, <br />Mining and Saftl J <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 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 during the previous year and no new changes to <br />the previous vear'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: Joe P. Conrado <br />Permittee Name: Meeker Sand & Gravel, Inc. <br />Address: 3251 RBC #4 <br />Phone Number <br />Fax Number: <br />P.O. Box 1550 <br />Meeker, CO 81641 <br />(970) 878-3671 <br />(970) 878-5751 <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 />Sign re of Corporate Officer, Owner, or Designee <br />Date