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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />/'/¢ F 0 r <br />ANNUAL FEES' anREPORT RE VEST <br />-6cAtee Construction Co. <br />Al-1986-147 <br />Harley Pit #1 <br />December 2, 2008 <br />$$791.00 (Due on or before your anniversary date) <br />Logan <br />'/DEC 0 8 2008) <br />Division <br />to M?n'snq and Safe; <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 />during the upcoming year, reclamation that wifl 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 vour 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 may are necessary, then no new may 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: <br />Ocm-Y e$) G7e-b-yay-t <br />Permittee Name: McAtee Construction Co. <br />Address: P.O. Box 1908 <br />- Sterling, CO 80751- <br />Phone Number: (970) 521-0651 <br />Fax Number: (970) 522-9725 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />//-7-0- o 'q <br />Date