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<br />AP 4- R?T- <br />ANNUAL FEE and REPORT REQ?U,?EST <br />PERMITTEE NAME: Thomas F & Ginger L Latham c/?v/ <br />PERMIT NO.: M-1981-058 <br />OPERATION NAME: DeBeque Gravel Pit <br />ANNIVERSARY DATE: September 7, 2008 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <br /> <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 tb occur-during=the upcomin <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 />vear's map are necessarv. then no new man is required. Drovided 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: Harold F. Elam <br />Permittee Name: Thomas F & Ginger L Latham <br />Address: 556 Struthers Ave <br />Grand Junction, CO 81501 <br />Phone Number: (970) 242-5370 <br />Fax Number: (970) 245-7716 <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 />Stature of orate Of icer, ner, or Designee <br />Date