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1 ? <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Aji:, + <br />ANNUAL FEE and REPORT REOUEST, <br />Delta County <br />M-1978-304 V <br />Triantos Gravel Pit <br />November 13, 2008 <br />$791.00 (Due on or before your anniversary date) <br />Delta <br />OCT 2 2 2000 L-"' <br />Division off; clamation, <br />Mining and Safety " <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning 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 <br />Report & Fee requirement is not met until we have received the following components: fee, report, and' <br />associated may. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous vear's map are necessary. then no new map is reauired. provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the 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: . Larry Record <br />Permittee Name: Delta County <br />Address: 501 Palmer St Ste 227 <br />Delta, CO 81416 <br />Phone Number: (970) 874-2100 <br />Fax Number: (970) 874-2114 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below ofl attach it tq s o along with your written report and map. Annual Report instructions are <br />Sigin-at(i -04Corpo ra Of£tcer, O mer; o7-Designee <br />I C) / I ?, Date <br />M:?PERMI7IMASTERDOCUMENTS?Ivi-AF-04