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,kr,- -p- R?--r <br />ANNUAL FEE and REPORT RE UEST <br />PERMITTEE NAME: Skanska USA Civil West Rocky Mountain District Inc. ' CLUVO <br />PERMIT NO.: M-1976-059 ? MAY r <br />OPERATION NAME: Cortez Pit 7 20?? <br />ANNIVERSARY DATE: June 17, 2010 01110i0n of Reclamation, <br />mining ? Safety <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Montezuma <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 vour revised written annual report and annual report may tc? 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 map are necessary, then no new may 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: Graig Wiekstram <br />Permittee Name: Skanska USA Civil West Rocky Mountain District Inc. <br />Address: 22419 CR G <br />P.O. Box 1660 <br />Cortez, CO 81321 <br />Phone Number: <br />(970) 565-8000 <br />Fax Number: <br />70 - s'rs - a/gam <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 />E==z ?L <br />Signature of Corporate Officer, caner, or Designee <br />s/lt / gotl0 <br />Date