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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />&01/ <br />ANNU FEE and REQUEST <br />? GG asser Construction, Inc. <br />"M-2001-052 <br />McCormick Pit <br />August 2, 2010 <br />RECEIVED <br />JUL 2 6 2010 <br />Division of Reclamation, <br />Mining & Safety <br />$$791.00 (Due on or before your anniversary date) <br />Kit Carson <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 u cp timing v, ear. ecl mation 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: Jim McCormick <br />Permittee Name <br />Address <br />Phone Number: <br />Pax Number <br />Grasser Construction, Inc. <br />18071 CR 31 <br />P.O. Box 192 <br />Stratton, CO 80836 <br />(719) 348-5383 <br />(719) 348-5931 <br />piep-- <br />-308g`7 4,ah jag aq <br />1-j i <br />C-6 910 8 ?? <br />If you have additional comments and/or information that should be provided to 4the 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 />/igglWat-ure of Corporate Officer, w r, or Designee <br />T-aa-,o <br />Date .