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<br />ANNUAL FEE and REPORT REQUEST V <br />PERMITTEE NAME: F? C & J Gravel Products, Inc. APP 2 7 jo r <br />PERMIT NO.: -M-1980-146 DIVISION OUpANli OF FIE O FIELp OFFICE <br />OPERATION NAME: Montoya Pit L OFFICE <br />ANNIVERSARY DATE: May 1, 2011 REC <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />APR 19 2U i i <br />COUNTY: La Plata pivWon or declamation, <br />MWng and Safety <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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: John Gilleland <br />Permittee Name: C & J Gravel Products, Inc. <br />i <br />Address: 27661 U.S. Hwy 160 E I <br />d' <br />Durango, CO 81301 <br />Phone Number: (970) 385-4112 <br />Fax Number: (970) 385-5014 <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 o Corporate O facer, Owner, or Designee <br />4- - z? - <br />Date