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AIF FEE and REPORT REQUEST <br />?`?° <br />PERMITTEE NAME:: Y & K No. 1, LLC RECEIVED <br />PERMIT NO.: 1981-121 I ft 21 2010 <br />OPERATION NAME: Hale Pit aka Earl's Pit of #W4090? <br />ANNIVERSARY DATE: July 23, 2010 MHIil? ? ??Q'Y <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: El Paso <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 />_.__..____?eclaltlation accomplish de to date and during the preceding-ye.ar._n_ewslisturbances_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 vour 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 vear'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: foe Kraig <br />Permittee Name: <br />Address <br />S & K No. 1, LLC <br />5000 North Park Dr. <br />P.O. Box 7650 <br />Colorado Springs, CO 80933 <br />Phone Number: (719) 599-8100 <br />Fax Number: <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 />:JD nip r,J PrR A L.>?}s Oi-sTu2l??'O /- & AS7- E"t?R . <br />i1?1/-?0 ? /?' O Gv??O f?RNAL??;??f?i9.s <br />Si re o orporate fficer, Owner r Designee <br />tars Pr7-y?R? <br />U ?/9 d D <br />Date //