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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Construction, RLLP <br />1998 -038 <br />Two Rivers <br />It <br />5eEIvED <br />'JUL 272010 <br />D ivision of Reclamaffon, <br />Mining & Safety <br />August 3, 2010 <br />$$791.00 (Due on or before your anniversary date) <br />Pueblo <br />"El" <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-tFe- 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: Joe C. Baxter <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 />Si ature of Corporate Officer, bwner, or Designee <br />Date <br />C <br />Permittee Name: <br />K0r land Construction, RLLP <br />Address: <br />P.O. Box 580 <br />2101 Main Street <br />Rye, CO 81069 <br />Phone Number: <br />(719) 489 -3385 <br />Fax Number: <br />(719) 489 -2265 <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 />Si ature of Corporate Officer, bwner, or Designee <br />Date <br />