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KJ? *_ U V_ <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Weber Sand & Gravel, Inc. 17 <br />PERMIT NO.: M-1995-056 c? <br />OPERATION NAME: Weber Pit No 2 <br />ANNIVERSARY DATE: September 18, 2008 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Archuleta <br /> <br />SEP 0 a 2008 v <br />Dibision tU: i.w1?,i7 v!i1©d7 <br />lUiinin.9 and sa afy <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 distur-banes-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 man are necessarv, then no new man 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: Andy Weber <br />Permittee Name: Weber Sand & Gravel, Inc. <br />Address: 2980 E. Hwy. 160 <br />Pagosa Springs, CO 81147-9741 <br />Phone Number: (970) 264-4568 <br />Fax Number: (970) 264-9089 <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 C orate Officer, Owner, or Designee <br />Date