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A r-7 - 2 ?-r <br />ANNUAL FEE and REPORT RE UEST <br />vl?r <br />PERMITTEE NAME: Granby Realty Holdings, LLC ,s <br />PERMIT NO.: ?M-2006-075 ? MAY 2 7 2010 <br />OPERATION NAME: Overlook Mine DK*bn of RacWmalion, <br />ANNIVERSARY DATE: June 28, 2010 Uninp and SOety <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Grand <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 anticiR ted 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 map t:o this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />man. 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: -Lmoo Rad@,Q&: <br />?Lc' A?2/Z l,,S <br />Permittee Name: Granby Realty Holdings, LLC <br />Address: P.O. Box 1110 <br />999 Village Road <br />Granby, CO 80446 <br />Phone Number: (970) 9,16 ;944- 83 ?- - 57-05 <br />Fax Number: (970) 926 99 8j / - 0 1 z- <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 />- /(Z <br />Signatur f Co orate Officer, Owner, or Designee <br />SZ o <br />Date