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05110/2010 17:04 FAX <br />i <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />P"r 4- 9-'fLr <br />ANNUAL FEE and REPORT REOUEST <br />Eastern Colorado Aggregates, LLLP <br />M-2006-013 <br />Potts Pit #2 <br />June 21, 2010 <br />$791.00 (Due on or before your anniversary date) <br />Ruerfano <br />IA 0002/0002 <br />RECE'VEn <br />Lf""IN 14 2090 <br />Division of Reclamau. <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 />shalt 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-disturbaiices-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 may 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 vear's map are necessarv. 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. Ronda Neumeister <br />Permittee Name: Eastern Colorado Aggregates, LLLP <br />Address: P.O. Box 307 <br />Holly, CO 81047 <br />Phone Number: (719) 537-0117 <br />Fax Number: (719) 537-0115 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />be w or attach it to thi form along with your written report and map. Annual Report instructions are enclosed. <br />Si ature of Corp r e Officer, Owner, or Designee <br />Date