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AN AL FEE and PORT REQUEST <br />PERMITTEE NAME: fiz-sbmidt Construction Company <br />PERMIT NO.: 1988-044 <br />OPERATION NAME: Coal Creek Resources <br />ANNIVERSARY DATE: March 28, 2009 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Arapahoe <br /> <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 prece -ding 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 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 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: Scott Davis <br />Permittee Name: Schmidt Construction Company <br />Address: 2635 Delta Dr. <br />Colorado Springs, CO 80910 <br />Phone Number: <br />Fax Number: <br />(719) 392-4207 <br />(719) 392-4245 <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, Own r, or Designee <br />CiEwE® <br />Date AAR 18 2009 of ROGMMSOM, <br />/'2MWNW dSaf*