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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Nir j, Qf-r <br />ANNUAL FEE and REPORT REOUEST <br />t?'City of Grand Junction <br />/M-2007-005 <br />Riverside Parkway <br />February 14, 2011 <br />$504.00 (Due on or before your anniversary date) <br />Mesa <br /> <br />1.,',,; ^ 1 2011 <br />?/ Division of Rwle?r , <br />.J Mining A Safety <br />- <br />-- - - According to-G.R.S.-34-32.5-116 or-C.R.S. 34-32-116, each year, on--the-anniversary- date -of- the-permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning 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 may to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated may, If no new disturbances or reclamation have occurred during the previous year and no <br />new chances to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the 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 L. Shanks <br />Permittee Name: City of Grand Junction <br />Address: 250 N 5th Street <br />C;1n o GraAr-?bn <br />Z So ry. 5-? ree-- <br />Grand Junction, CO 81501 W n r- 'h o r. , Go 8' S b 1 <br />Phone Number: (970) 244-1543 9-7Z y y- l S y Z <br />Fax Number: (970) 256-4014 ( `f-Zo) Z 5 (Q - <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 <br />enclosed. <br />Signature of Corporate Officer, Owner, or Designee RECEIVED <br />3/,? MAR <br />212011 <br />Date DIVIllon of Reclamadon, <br />Mining & Safety <br />M: PERMIT1MASTERDOCUMENTS\M-AF-04