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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />R P <br />A AL FEE and REPORT REOUEST <br />Grasser Construction & Paving, LLC <br />/M-2009-010 <br />Stewart Pit II <br />March 20, 2011 <br />$$323.00 (Due on or before your anniversary date <br />Kit Carson <br />(fC 5 <br />o k.- <br />RECE <br />P"MAR 21 m i <br />Dvislun o ;reclamation, <br />r,??? ?? ?rcd .S ety <br />j o/70 <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 feet 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 chances 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: James McCormick <br />Permittee Name: Grasser Construction & Paving, LLC <br />Address: 18071 County Road 31 <br />Stratton, CO 80836 <br />Phone Number: (719) 348-5383 <br />Fax Number: (719) 348-5931 <br />m eco rm' 0 /C C k eQ U4_-CCM v ?cl a n4 = Lt o <br />Zo8g7 t.lS i4wg ?q <br />Sne 4 ;moo v CQ Po&--,t, <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 />ec..? <br />ignature of Corporate Officer, Owner, or Designee <br />3- 0- 11 <br />Date