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Of <br /> ANNUAL FEE and REPORT REQUEST <br /> <br />PERMITTEE NAME: ?Sunnyside Gravel & Excavation <br />PERMIT NO.: 114-1986-033 <br />OPERATION NAME: Hess Pit <br />ANNIVERSARY DATE: March 11, 2011 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: La Plata <br />ftEcollso <br />BAR zA jz11 <br />edam*don, <br />plvleO nl g SAW <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 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 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: Alton Hess <br />Permittee Name: Sunnyside Gravel & Excavation <br />Address: 9983 Hwy 550 <br />Durango, CO 81303 <br />Phone Number: (970) 247-1596 <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it tot is form along with your written report and map. Annual Report instructions are enclosed. <br />&A- <br />S(lVature of Corpoi e Officer, Owner, or Designee <br />'3 - ?- <br />Date