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ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Pioneer Sand Com/pany Inc w - <br />PERMIT NO.: M-1977-057 OCT 14 2009 <br />OPERATION NAME: Fedinec Pit Division or ? clam?tfon, <br />ANNIVERSARY DATE: November 22, 2009 Wing and Safety ?' <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Moffat <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 />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: Joe Kraig <br />Permittee Name: Pioneer Sand Company Inc <br />Address: P.O. Box 7650 <br />Colorado Springs, CO 80933 <br />Phone Number: (719) 599-8100 <br />Fax Number: (719) 593-0167 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />low or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />i?o 1--t t,? i-j ),q X71, s <br />???e of orporate O c Owner, or Designee <br />?? ? /29 <br />Date