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?W 4 %Q T- <br /> ANNUAL FEE and REPORT RE UEST <br />PERMITTEE NAME: Canyon Sand & Gravel -01 <br />PERMIT NO.: M-1988-057 <br />OPERATION NAME: Canyon Sand & Gravel <br />ANNIVERSARY DATE: August 16, 2009 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Archuleta <br />RIME" <br />AUG 17 2009 <br />Division of tjoc,aMS60" <br />MIRing 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-pr-eeeding-year; new-disturbances-that-are._antiaipated-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 />map. 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 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: Robert S. Scott <br />/ <br />"? 4?.ss <br />Permittee Name: Canyon Sand & Gravel aw'ntte- rev or: f hA5 /10 <br />Address: P.O. Box 4362 rle.ty' exCc?vr,??i©.°t o? %'ed4A4_2a f 1114 <br />Pagosa Springs, CO 81157 o revyo v S i k tc /, ?1 l{Y txcay ?c <br />?rv et(a t!av?7 1--,(K e Av G'oes'{e_ <br />Phone Number: (970) 731-4707 cz„ rsfahdaycf of ;(e revuer?+-lKq le--d., <br />Fax Number: (970) 731-4707 a,ynr?,t,-?rlc, /So <br />r' <br />F!.?r rite Crl' lt•e S G Qlr?/(+rt•S'/i.v•- ct-- - 0djAc?Wr <br />If you have additional comments and/or information that should be provided to the Di/vision, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />~'te ?n- co GL Pa.lG! Qreu. <br />1 r <br />- ? &J+G ? "!? ??8(iIL'?CO/tS Cc?r1C?r/SCOtiI . <br />Signature of Corporate Officer, Owner, or Designee <br />?/iy/o <br />Date <br />"r ?aq d " was a-d?ed fa Gi, ?Lr e c tcca vc.?o v- <br />lYZa.Erit?! rytore, itea,?eri?•evaila.6/.?- 6cf <br />?t'dla? ci6o ve wa rev- rc?w r?uzfe?.c c A[e. <br />r?Cee•Esrdc ?o ??e --Fio.??s.o'-? c?'-??p etcls?c.?