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vqjz ?- AP r <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT RE VEST <br />S & S Aggregate, Inc <br />M-1983-159 <br />Gleason Pit <br />January 30, 2011 <br />$791.00 (Due on or before your anniversary date) <br />Montrose <br />RECEIVEID <br />MAR 09 2011 <br />l? Division u+ neuamation, <br />/ Mining and Safety <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-,-new- disturbances-t-hat--are-anticipated-to - occur-- <br />during g 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 writte?Ze p ort. <br />0"ELuk 5 u (? as 1 b?? mss- ?necessary <br />Division recordmd?te the following permittee contact information. Please verify and make any changes: <br />Permittee Contact: Jim Sutherland <br />Permittee Name: S & S Aggregate, Inc <br />Address: P.O. Box 216 <br />Egnar, CO 81325 <br />Phone Number: (970) 428-9406 <br />Fax Number: (888) 570-5327 <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 orporate Officer, Owner, or Designee <br />a a.? .z v ?? <br />Date