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PERMITTEE NAME: <br />PERMIT NO.: <br />RF !?' ?Z,R'-7 <br />ANNUAL FEE and REPORT REOUEST <br />Paul Morgan Excavating, Inc. <br />M-2006-077 <br />W-CONED <br />'DEC 14 2009 <br />OPERATION NAME: Morgan Pit Division of Reclamation, <br />Mining and Safety <br />ANNIVERSARY DATE: January 31, 2010 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Huerfano <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 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 vear's man 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: Paul Morgan <br />Permittee Name: Paul Morgan Excavating, Inc. <br />Address: 581 County Road 420 <br />P.O. Box 82 <br />La Veta, CO 81005 <br />Phone Number: (719) 742-3155 <br />Fax Number: (719) 742-3155 <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 />CpivSu?,?ka'? <br />Signature of Corporate O ice , Owner, o Designee <br />17?c.1t Zoo9 <br />Date