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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />f <br />AN AL FEE and REPORT REOUEST <br />Leone Sand and Gravel LLC <br />M-1994-006 <br />Emerald Vista Estate <br />March 11, 2011 <br />RECEIVED <br />"MAR 02 2011 <br />?ivislon of Reclanow, <br />Mining $ Safety <br />$$323.00 (Due on or before your anniversary date) <br />Las Animas <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 andmap 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 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 Previous year's map are necessary, then no new map is required, provided that the Operator shall <br /> state 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 L. Leone Jr <br />Permittee Name: Leone Sand and Gravel LLC <br />Address: 2400 E Main Street <br />Trinidad, CO 81082 <br />Phone Number: (719) 846-4170 <br />Fax Number: (719) 845-0605 <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, O ner, or Designee <br />Z _2?( - <br />Date