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<br />AF '?'.. Q'PT- <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REOUEST <br />Pioneer Sand Company Inc <br />M-1985-082 ? <br />Rock Pit Mine <br />December 30, 2008 <br />$323.00 (Due on or before your anniversary date) <br />Moffat <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 <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation_accompllshed-to_date_and-dur-ing_the-preceding year.,- new disturbances that-are-anticipated-to-occar <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 year's map 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: Joe Kraig <br />Permittee Name: Pioneer Sand Company Inc <br />Address: P.O. Box 7650 <br />Colorado Springs, CO 80933 <br />Phone Number: (719) 599-8100 <br />Fax Number: (719) 598-7605 <br />If you have additional comments and/or information that should be provided to the D' -ision, please provide it <br />below or attach it to this form along with your written report and map. Annual Repo structions are enclosed. <br />1%c77e iT Tiffs ? s? l1'Or/ <br />eV7 <br />Sign of Co rate Office ner, or Designee <br />Date