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t <br />I <br />RE <br />A FEE and R&PRT <br />OUEST <br />PERMITTEE NAME: Willits Company, Inc. <br />PERMIT NO.: VS1-2010-034 <br />OPERATION NAME: McEndaffer Mine <br />ANNIVERSARY DATE: June 17, 2011 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Weld <br /> <br />RE10E1vto <br />IJUN202 <br />`Division ofFfsQl? <br />7p minlnp a 8af4?on, <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 t_he_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: Bob Willits <br />Cheyenne, WY 82003 <br />Permittee Name: Willits Company, Inc. <br />Address: P.O. Box 825 <br />Phone Number: (307) 634-2300 <br />Fax Number: (307) 634-2310 <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 fo along with your written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />6-161- <br />Date <br />