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DT <br />C's <br />pF 4C VQ <br />ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Hardrock Sand & Gravel <br />PERMIT NO.: M-1977-443 <br />OPERATION NAME: Moon Pit No 2 <br />ANNIVERSARY DATE: November 8, 2008 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Moffat <br />JAN 122009 v <br />Division of Reclamation, <br />Mining and Safety 3y' <br />_ According to C.R.S. 34-32.5-116_ or C.R.S. 34-3.2-116 _ each year, on the anti"y_ersary_date-of_the_-P.ermit,. 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 vour revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map 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 required, 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: Pat J. Weber <br />Permittee Name: Hardrock Sand & Gravel <br />Address: P.O. Box 141 <br />Phone Number: <br />Fax Number: <br />Craig, CO 81626 <br />(970) 824-4053 <br />(970) 824-4053 <br /> <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 />Sig" ture of Corporate Officer or Owner <br />/- 0-09 <br />Date