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AN UAL FETE and REPORT REOUEST <br />PERMITTEE NAME: [?-S & K No. 1, LLC <br />PERMIT NO.: 41-1981-121 <br />OPERATION NAME: Hale Pit aka Earl's Pit <br />ANNIVERSARY DATE: July 23, 2009 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: El Paso <br />RWRWED <br />7 2009 <br />OJUL 07' <br />Dh*i en of taeclamatioa, <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--te-date-and-dur-ing-the-preceding-year,_new disturbances-that_are_antic,ipated-to_oc_cur__ <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 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: Joe Kraig <br />Permittee Name <br />Address <br />Phone Number: <br />Fax Number: <br />S & K No. 1, LLC <br />5000 North Park Dr. <br />P.O. Box 7650 <br />Colorado Springs, CO 80933 <br />(719) 599-8100 <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 />L /X, 7X7 ID 44111,16 4.--1-7v, 7-y - No <br />Si re o orporate f er, Owner, or Designee <br />Date