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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />'P, i?7 *'. ?" ?-1' <br />ANNUAL FEE and REPORT REQUEST <br />James L Treat <br />,/M-1980-041 <br />Rock Gulch Gravel Pit <br />April 3, 2011 <br />RECEIV9D <br />1/ MAR 3 0 2011 <br />Division of Reclamation, <br />Mining & Safety <br />$791.00 (Due on or before your anniversary date) <br />Chaffee <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 may to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee. resort, 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 may are necessary, then no neiv man 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 L. Treat <br />Permittee Name: James L Treat <br />Address: 225 G St <br />Salida, CO 81201 <br />Phone Number: (719) 539-2215 <br />Fax Number: (719) 539-2588 <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 />onto <br />Signatur f Corpora i r, Owner, or Designee <br />March 25,. 2011 <br />Date