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ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: West End Gravel Company <br />PERMIT NO.: ,-M-2001-002 <br />OPERATION NAME: Weimer One Gravel OcT 0 V 2010 <br />Division ?iof a Saf,- tzon, <br />ANNIVERSARY DATE: September 12, 2010 R <br />?l;`ra? and ..i'bj <br />ANNUAL FEE DUE: $791.00 (Due on or before your annive ary date) <br />COUNTY: Montrose <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_th?e receding eyeal, n,et, dis..tu baWes,.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 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: Bob Sutherland <br />Permittee Name: West End Gravel Company <br />Address: 29703 Hwy 97 <br />P.O. Box 889 <br />Nucla, CO 81424 <br />Phone Number: (970) 864-2177 <br />Fax Number: (970) 864-7980 <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 />Signature of Corporate Officer, Owner, or Designee <br />Date