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61Z i_ ? PT <br />ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Hocker Construction, LLP <br />PERMIT NO.: M-1977-446 <br />OPERATION NAME: Ignacio Pit <br />ANNIVERSARY DATE: December 30, 2008 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: La Plata <br />R OFIVED <br />JAN 0 2 ,2009 ,,? <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 />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 may 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 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 since for a written report. <br />- -Division-records- indicate-the-following-permittee-contact information: Please-verify-and-make-any-necessary ------ <br />changes: <br />Permittee Contact: Roy Hocker <br />Permittee Name: <br />Address <br />Phone Number: <br />Fax Number: <br />Hocker Construction, LLP <br />P. O. Box 627 <br />Ignacio, CO 81137 <br />(970) 563-9533 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature o C rporate Officer, Owner, or Designee <br />ALL), 5 <br />Date