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L %41 <br />A� L AL FEE and REQUEST <br />PERMITTEE NAME: '✓Grand Junction Pipe & Supply Co. w <br />PERMIT NO.: A- 1998 -084 ' DEC 2 4 2009 <br />OPERATION NAME: Whitewater Pit Divigivn of Reclamatlen, <br />Mlning and Safety <br />ANNIVERSARY DATE: January 7, 2010 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <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. yea.. disturbances _.thaLare—aaticipated- 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 man 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 chances to <br />the previous vear's map are necessarv. then no new map is reauired. 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: Edward J. Settle <br />Permittee Name: Grand Junction Pipe & Supply Co. <br />Address: P.O. Box 1849 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243 -4604 <br />Fax Number: (970) 243 -6703 <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 />Signature of orporate Officer, Owner, or Designee <br />12—x/-05 <br />Date <br />