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A? <br />ANNUAL FEE and REPORT REOUEST CEDVED <br />PERMITTEE NAME: i7Butala Construction Company <br />SAP 2 7 2010 <br />PERMIT NO.: JM-1977-170 Dk6sion <br />OPERATION NAME: Butala Gravel Pit Wing ?mci Safsty <br />ANNIVERSARY DATE: October 1, 2010 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Chaffee <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,performe"uring_the _coming_y_ear,.the-dates-fo?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: Frank Butala <br />Permittee Name: Butala Construction Company <br />Address: 9000 CR 152 <br />P.O. Box 907 <br />Salida, CO 81201-9519 <br />Phone Number: (719) 539-2521 <br />Fax Number: (7--1-9)-539-2523 <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 />4- z X. L., <br />"Oe ?w <br />orate Officer, Owner, or Designee <br />Signs re o7/, rp <br />2 Da