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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />AF r r <br />ANNUAL AE a d REPORT REQUEST <br />S owstorm Sand & Gravel, LLC <br />1983-084 <br />Snowstorm Placer <br />Or-- <br />X62 <br />RECEIVED <br />JUL 2 2 2009 <br />Division or reclamation, <br />Mining and Safety <br />July 28, 2009 <br />$$791.00 (Due on or before your anniversary date) <br />Park <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 vour 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 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: Eric Blaylock <br />Permittee Name: Snowstorm Sand & Gravel, LLC <br />Address: P.O. Box 1150 <br />Silverthorne, CO 80498 <br />Phone Number: (970) 468-2521 <br />Fax Number: (970) 468-2756 <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 />Ave ,. e&a??k <br />Signature of Corporate Of cer, Owner, or Designee <br />®7-r' "21 <br />Date