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<br />T"? f 4- Re-r <br />ANNUAL FEE and REPORT REOUEST <br /> <br />PERMITTEE NAME: Z Oldcastle SW Group, Inc. dba Telluride Gravel <br />PERMIT NO.: / M-1976-032 RECI'I'VEJ) <br />OPERATION NAME: Alexander Pit JUN 1 4? 20 l o <br />ANNIVERSARY DATE: June 17, 2010 <br /> Division of Reclamation <br /> <br />ANNUAL FEE DUE: <br />$791.00 (Due on or before your anniversary date) , <br />Mining & Safety <br />COUNTY: San Miguel <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: Greg Homan <br />Permittee Name: Oldcastle SW Group, Inc. dba Telluride Gravel <br />Address: Drawer U 2? 0 fly y 6 Z S` <br />QEV"SE "TO t'ELLiIR.?D? . ?y $l ¢3$? <br />Cortez, CO 81321 <br />Phone Number: (970) 728-3775 <br />Fax Number: (970) 728-3015 <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 o Corporate Officer, Owner, or Designee <br />Date