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ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: !' Oldcastle SW Group, Inc. d.b.a. B & B Excavating <br />PERMIT NO.: YM-1997-026 R?? 1 ? <br />OPERATION NAME: Carol Ann Pit <br />S E P ANNIVERSARY DATE: September 8, 2008 <br />pWision otand Safety <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date'v Mining <br />COUNTY: Eagle <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 <br />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 & Fee <br />requirement is not met until we have received the following components: fee, report, and associated map. If no <br />new disturbances or reclamation have occurred during the previous year and no new changes to the previous <br />year's map are necessary, then no new map 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: <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Jason Burkey <br />Oldcastle SW Group, Inc. d.b.a. B & B Excavating V <br />632 <br />(97a)-9 2?53x-- <br />Oldcastle SW Group, Inc. <br />P.O. Box 487-0 <br />Eagle, CO 81631 <br />70 328 1-731 <br />3z?? I73. <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 along with your written report and map. Annual Report instructions are enclosed. <br />"o?4 Avsiz . <br />Signature of C orate Officer wner, or Designee <br />?? 9 U <br />??-,Date <br />