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? j:. * R?',- <br />ANNUAL FEE and REPORT RE VEST <br />PERMITTEE NAME: ? Rocky Mountain Aggregate & Construction, LLC <br />PERMIT NO.: M-1997-027 <br />OPERATION NAME: Moonscape Pit <br />ANNIVERSARY DATE: January 30, 2011 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Delta <br /> <br /> <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 />.°.?ri?3if2?sar "nt., hn ,to. d.nt0ii?11'dg = rP Rg¢P?'x! - ] ..i}l O@("R: - w_ _ _ <br />are <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 may 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: Zane Luttrell <br />Permittee Name: Rocky Mountain Aggregate & Construction, LLC <br />Address: 23625 Uncompahgre Rd <br />Montrose, CO 81403 <br />Phone Number: (970) 209-8340 <br />Fax Number: (970) 252-1265 <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 />gnatur o orate Officer, Owner, or Designee <br />l 16 170(e) <br />Date