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ANNUAL FEE and REPORT REOUEST <br />WCWVW <br />PERMITTEE NAME: PNuvemeo. LLC / <br />PERMIT NO.: /M-2008-050 ? AUG 02 2010 <br />OPERATION NAME: October Ore Pile Reclaamaton Drivi win ei Rz.ba w0on, <br />A,Sinirog and Safety <br />ANNIVERSARY DATE: August 20, 2010 <br />ANNUAL FEE DUE: $518.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <br />Acordipg to C.R.$._34-?2 5-116 or C.R.S 34_32__116, each year, on the annersary date of the permit -AA- <br />-L operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning 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 <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the 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: <br />Permittee Name: <br />Address: <br />Henry M. Carter <br />Nuvemco. LLC <br />I <br />(.0 "C;-U ? r a0-N 1zhP'p- - <br />r ,_? rim l la w-- ? ? y, sz:36' <br />new , ? <br />Phone Number: *'?S3 - Y13 - ?04?t <br />Fax Number: {? - 9- ,* a/(0- / U yi <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 <br />enclosed. Z_. <br />Signaturt46'rate Officer, Owner, or Designee <br />Date <br />M: \PERMPIIMASTERDOCUMENTS/M-AF-02.DOC