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N V A FR? <br />ANNUAL FEE and REPORT REOUEST <br />?fr RECm im <br />PERMITTEE NAME: Silt Sand & Gravel, LLC <br />PERMIT NO.: M-2006-046 A? ? 20 1 <br />Division u6 neuamation, <br />OPERATION NAME: Grand River Park Project Mining and Safety <br />ANNIVERSARY DATE: April 27, 2011 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Garfield <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, tgLb -ances that are anticipated to occur <br />during the up'commg yeam Lion that wi a per orme urmg 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 may 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: 4*ff aborts SEAN` MEN` <br />Permittee Name: Silt Sand & Gravel, LLC <br />Address: 304 Highway 133 <br />Carbondale, CO 81623 <br />Phone Number: (970) 963-2296 <br />Fax Number: (970) 963-2412 <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 Corporate Of cer, Owner, or Designee <br />41 z? <br />Date <br />