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o? <br />ANNUAL t-'a' /ddPORT REQUEST <br />PERMITTEE NAME: iel J. Gaudreault and Barbara J. Gaudreault <br />PERMIT NO.: M-2006-081 <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Big "G" Gravel Pit <br />April 24, 2009 <br />$$791.00 (Due on or before your anniversary date) <br />Pueblo <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 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.suffce for a written report. <br />Division records indicate, the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Daniel J. Gaudreault <br />Permittee Name: Daniel J. Gaudreault and Barbara J. Gaudreault <br />Address: P.O. Box 69 <br />Phone Number: <br />Fax Number <br />Eilizabeth, CO 80107 <br />(303) 436-3081 <br />(303) 646-1451 <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 />r <br />gnature of orporate Officer, Owner, or Designee <br /> <br />RECEIVED <br />Y1 <br />9 2009 <br />Division of Reclamation, <br />Mining and Safety <br />'yl?r?lo9 <br />Date