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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />W A FREE a <br />Ctinental Materials Corporation <br />VM-2001-005 <br />Grisenti Farms Gravel Pit <br />May 23, 2010 <br />V <br />h CE <br />JUN 0 ; 2010 <br />f dLsr iP?: ?>> rwcl Lion, <br />latitaing and Safety <br />40 <br />$$791.00 (Due on or before your anniversary date) <br />Fremont <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 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: <br />A06P,6 1'4 pz oe <br />Permittee Name: Continental Materials Corporation <br />Address: ^ `vwf 96 East <br />Phone Number: ?19j- $923 <br />Fax Number: (qH? 566 6291 <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 />00 <br />Signature of Corp to Officer, caner, or Designee <br />Date <br />y11q C CO,S, iLU4 S'7' <br /> <br />719-gIS-0-7 D© <br />19 • y -7,1-• o 9?g&