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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />i RP 7- AX4711 EE and REPORT REQUEST <br />' -B' R Construction Company Inc <br />X1988-052 <br />Big R Pit <br />August 16, 2008 <br />$$323.00 (Due on or before your anniversary date) <br />Elbert <br />o1L <br />X4 <br />®dbZe 0' e«cEi iyw' Jo <br />Y6 ate End Say4,?Jy <br />aU6 3 2008 <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 />_--- --xeclamation_accQmplisbed_to-date-and- during_the_.preceding-y_ear--me_w 4iturbances.tb_at_are>anticipa_ d__+o.-occ1jr_ during <br />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 />man. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's may 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 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: Rick L. Hunt <br />Permittee Name: Big R Construction Company Inc <br />Address: 43160 CR 17-21 <br />Elizabeth, CO 80107 <br />Phone Number: (303) 646-6486 <br />Fax Number: (303) 646-9233 <br />lar nd <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it o this alon with your written report and map. Annual Report instructions are enclosed. <br />gJ? <br />Signature of Corporate Officer, Owner, or Designee <br />S'I(- () Date