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<br /> ANNUAL FEE and REPORT REOUEST <br /> <br />PERMITTEE NAME: Asphalt Constructors, Inc <br />PERMIT NO.: M-2008-085 <br />OPERATION NAME: Ft. Garland Pit <br />ANNIVERSARY DATE: April 28, 2010 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Costilla <br />CEOV <br />MAR 112010 <br />Division of Reclamation, <br />Mining & 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 duringthe 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 chanizes to <br />the previous year's map are necessary, then no new map is renuired, 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: Todd A. Stockebrand <br />Permittee Name: Asphalt Constructors, Inc <br />Address: 7040 Hwy 160 W <br />Alamosa, CO -8 t l01 <br />Phone Number: <br />Fax Number: <br />(719) 589-6671 <br />(719) 589-0927 <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 esignee <br />3--'1-10 <br />Date