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Lalk <br /> r <br /> ANN AL FEE and REPORT REOUEST <br /> LLC <br />t <br />A <br />R <br />PERMITTEE NAME: ggrega <br />es, <br />ange <br />Front <br /> 054 <br />1997 <br />VM <br />PERMIT NO.: - <br />- <br />OPERATION NAME: Parkdale Project <br />ANNIVERSARY DATE: January 11, 2011 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <br />'0'<1 <br />Y Thy, "t t? (r( t- _i <br />.. ?-. .. <.. l?f - .. a .l <br /> <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:-n-6 --disturbanees-that are-anticipated to-occur <br />. <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: Michael Sheahan <br />Permittee Name: Front Range Aggregates, LLC <br />Address: 1161 S Perry Street, Ste 110 <br />Castle Rock, CO 80104 <br />3 3" 7.3 6- 6 y 2 <br />Phone Number: 96-442 <br />Fax Number: (303) 736-6423 <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 />azj"--?/ <br />ignature of Corporate Officer, Owner, or Designee <br />0, 30 2 o/ o <br />Date