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<br />AdL FEE and REPORT REQUEST RECEIVED <br />PERMITTEE NAME: kReese Contracting MAY I v ` J ' <br />PERMIT NO.: LM-1986-048 Divlelon of Reclamation, <br />Tv Mining & Safety <br />OPERATION NAME: Nicholson Gravel Pit <br />ANNIVERSARY DATE: May 22, 2011 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Morgan <br />S 34-32-116yeach year, on the annivers a date of the permit, an <br />--A KS _3_432.5-116-oL-C.R, . <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 vour revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes 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: Galen Reese <br />Permittee Name: Reese Contracting <br />Address: P.O. Box 105 <br /> <br />Atwood, CO 80722 <br />Phone Number: (970) 522-0867 <br />Fax Number: <br /> <br /> <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 />Sign Lure orporate Offic r, Owner, or Designee <br />-/21- w <br />Date <br />M:TERMIT\MAS TERDOCUMENTS\N4-AF-04 <br />. <br />..