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A?p -i- aer <br />ANNUAL FEE and REPORT RE VEST RECEIVED <br />PERMITTEE NAME: Glacier Gravel Products ,-1UL 13 2009 <br />PERMIT NO.: M-1985-0016,--' <br />Divisim of Reclaretatiaw, <br />OPERATION NAME: J & J Pit ? Miaing and Safety <br />ANNIVERSARY DATE: June 27, 2009 ? <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: La Plata <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-i he-preceding:year,- ie.,w-distur-bancesAhat-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 may to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />?m i. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />'the previous vear's map are necessarv. 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: Jim Helmericks <br />Permittee Name: Glacier Gravel Products <br />Address: 995 Hwy 3 <br />Durango, CO 81301 <br />Phone Number: (970) 259-3995 <br />Fax Number: (970) 375-7880 <br />If you have additional comments and/or information that sh d be provided to the Division, please provide it <br />below or attach it to this form along with your written reportnd map. Annual Report instructions are enclosed. <br />P\A <br />Signature of Corporate e Officer, Owner, or Designee <br />? (?-. -- ? - n <br />Date <br />4qA eel <br />??8