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?F * R?T <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Weber Sand & Gravel, Inc. <br />M-20072007-010 <br />Martinez <br />April 26, 2009 <br />$323.00 (Due on or before your anniversary date) <br />Archuleta <br />CE <br />MAR 19 2009 ? <br />Division of Reciamation, <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 te, 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 vear's man are necessarv. then no new man 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: Andy Weber <br />Permittee Name: Weber Sand & Gravel, Inc. <br />Address: 2980 E. Hwy. 160 <br />Pagosa Springs, CO 81147 <br />Phone Number: (970) 264-4568 <br />Fax Number: (970) 264-9089 <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 />4a?? uuv-? <br />Signature of Co rate fficceer, Owner, or Designee <br />3 ??-0 l <br />Date