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4? lp *- <br /> ANNUAL FEE and REPORT REOUEST <br />PE % <br />RMITTEE NAME: Glenn E Sessions & Sons, Inc. <br />t <br />PERMIT NO.: M-2003-058 <br />OPERATION NAME: Fairbanks Pit <br />ANNIVERSARY DATE: December 4, 2008 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Jackson <br />RECEIVED <br />DEC 0 4 2008 v <br />Division of Reclamation, <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 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 disturbances that are anticipated to occur <br />wring "the upcommg year, rec`TamaTibnth-at?be peTformed-durmg-the-coming-year; the-dates-fer-the--bea nnm-,-er=--=.- <br />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 map. <br />If no new disturbances or reclamation have occurred during the previous year and no new changes to the <br />previous year's map are necessary, then no new map is required, provided that the Operator shall state this <br />in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above <br />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: <br />Joe Sessions <br />Permittee Name: Glenn E Sessions & Sons, Inc. <br />Address: 33492 Hwy 125 <br />P.O. Box 1076 <br />Walden, CO 80480 <br />Phone Number: (970) 723-4944 <br />Fax Number: (970) 723-8344 <br />If you have additional comments and/or information that should be provided to the Division, please provide it below <br />or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signatur of Corporate Offic , Owner, or Designee <br />I a-5-Db <br />Date