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aV - 9?.Q Or <br />ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Western Slope Aggregates <br />PERMIT NO.: M-1981-207 <br />OPERATION NAME: Blue Pit <br />ANNIVERSARY DATE: March 8, 2009 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Garfield <br />C f <br />4 DIN ? <br />pivision 01 Snd ? ? <br />M109 <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 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 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 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: William M. Roberts <br />YT <br />Permittee Name: Western Slope Aggregates <br />Address: 304 Highway 133 <br />Carbondale, CO 81623 <br />Phone Number: (970) 963-9424 <br />Fax Number: (970) 963-1554 <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 />'s-f - az? <br />1.) - 1L- <br />Signature of Corporate Officer, Owner, or Designee <br />2&, A aoo 9 <br />Date