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x ._ <br />G y ' <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REOUEST <br />Parkerson Construction Co. <br />M-1978-323 <br />Woodring Pit <br />November 22, 2010 <br />$791.00 (Due on or before your anniversary date) <br />Mesa <br />REGE'iED <br />AMR G Zola <br />Divisior; <br />Minn, - °sty <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?ate an`dau`ring the-prece- ing year, new istur ances tuaf are-anticipated-to occur during the upcoming year,- reclamation that will be performed-during-the <br /> 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 vear's map are necessarv, then no new map is reauired. 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: Alan Parkerson <br />Permittee Name: Parkerson Construction Co. <br />Address: 710 S. 15th St <br />Grand Junction, CO 81501 <br />Phone Number: (970) 242-8134 <br />Fax Number: (970) 242-8977 <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 rm along with your written report and map. Annual Report instructions are enclosed. <br />Signature of Co orate Officer, Owner, or Designee <br />2 4/za <br />Date