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<br />1, <br />ANNUAL FE nd RLP 9RIKEOUES-T <br />PERMITTEE NAM (i/Rocky Mountain Materials & Asphalt, Inc. <br />PERMIT NO.: (4-1992-016 <br />OPERATION NAME: Penrose Ranch's <br />ANNIVERSARY DATE: June 24, 2010 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <br />o& <br />PECelvw <br />/,-,Jut is <br />ztv <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-aee-omplished=to-date-and-dur-i_ng-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: Rob Mangone <br />Permittee Name: Rocky Mountain Materials & Asphalt, Inc. _ <br />Address: 1910 Rand Ave <br />Colorado Springs, CO 80906 <br />Phone Number: (719) 473-3100 <br />Fax Number: (719) 473-3109 <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 />zv\ f Corporate O ffi r, ner, or Designee