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14"F 4 R:P< <br />AL FEE and REPORT REQUEST <br />RECEIV60 <br />PERMITTEE NAME: ' Granby Realty Holdings, LLC <br />? JUN 13 2011 <br />PERMIT NO.: /M-2006-075 Division of Reclamation, <br />OPERATION NAME: Overlook Mine Mining and Saf t <br />ANNIVERSARY DATE: June 28, 2011 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Grand <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, showin t extent, of ,q u-, disturbances to affected ands <br />y 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 man to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />man. 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 may 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: Kyle Harris <br />Permittee Name: <br />Granby Realty Holdings, LLC <br />Address <br />Phone Number: <br />P.O. Box 1110 <br />999 Village Road <br />Granby, CO 80446 <br />(970) 887-5205 <br />Fax Number: (970) 887-ice 9 (OZ--5 ' ' -10 " <?S'J6 -7 - C1 `bZ 3 <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 />Av- <br />SignaVe of Corporate Officer, Owner, or Designee <br />-'? hs?A-l <br />Date