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P n'r'uaa Ltzw -- <br />yt?ANNUAL FEE and REPORT REOUEST ItECEP D <br />PERMITTEE NAME: e/ McStone Aggregates, LLC „?II ?? <br />PERMIT NO.: M-2006-016 AUG 2 4 2009 <br />OPERATION NAME: Perkins Sandstone Division of Reciamail oiR, <br />? Mining and Safety <br />ANNIVERSARY DATE: July 21, 2009 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Dolores <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 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 />man. 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 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: Deren?rtd-I?aStoee <br />Paul Aldama or Casey McClellan <br />Permittee Name: McStone Aggregates, LLC <br />Address: 1?49-.-8eK4$3-- P. O. Box 1525 <br />EeAezr E4412,2"430• <br />Phone Number: (970) 565-2603 <br />Fax Number: (970) 565-0276 <br />Dolores, CO 81323 <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 />, Paul Aldama, Office Manager <br />Signature of Corporate Officer, Owner, or Designee <br />22 AUG 2009 <br />Date <br />PLEASE SEE ATTACHED MAP.