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1\F *Q?T- <br />ANNUAL FEE and REPORT RE UEST <br />PERMITTEE NAME: Sky Ute Sand & Gravel, LLC <br />PERMIT NO.: M-2002-094 <br />OPERATION NAME: Allen Pit <br />ANNIVERSARY DATE: January 23, 2009 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Montrose <br />RECEIVED <br />JAN 14 2009 --- <br />Division of Reciatna f on, <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 man 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 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: David A. King <br />Permittee Name: Sky Ute Sand & Gravel, LLC <br />Address: P.O. Box 350 <br />Ignacio, CO 81137 <br />Phone Number: (970) 382-0609 <br />Fax Number: <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 />??4' e4t <br />Signature of Corporate Officer, Owner, or Designee <br />//fz/? <br />Date r/