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Al;? * OT <br />ANWAL FEE and REPORT REQUEST <br />PERMITTEE NAME: ?%ldcastle SW Group, Inc. d.b.a. B & B Excavating <br />PERMIT NO.: / M-1986-104 PF-CF-14 <br />OPERATION NAME: Montgomery Pit <br />ANNIVERSARY DATE: May 24, 2011 MAY 2 3 2011 <br />Division or Kectamatlon, <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) mining and Sa <br />COUNTY: Eagle <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 vear's map are necessarv, 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: Jason Burkey <br />Permittee Name: Oldcastle SW Group, Inc. d.b.a. B & B Excavating <br />Address: P.O. Box 4870 <br />Phone Number: <br />Fax Number: <br />Eagle, CO 81631 <br />(970) 328-1734 <br />(970) 328-1735 <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 />Signa re of Corporat Officer, owner, or Designee <br />Date