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•/\ 401T— <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: McStone Aggregates, LLC <br />PERMIT NO.: / M- 2006 -016 <br />OPERATION NAME: Perkins Sandstone <br />ANNIVERSARY DATE: July 21, 2011 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Dolores <br />-Z AUG 14 2011 <br />Division of Reclamation, <br />Mining and Ste' <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 <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 your revised written annual report and annual report man 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 man are necessary. then no new man 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 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: Casey N. McClellan or <br />Nathan A. Barton Added <br />Permittee Name: McStone Aggregates, LLC <br />Address: P.O Box 1525 <br />12 August 2011 <br />Date <br />Dolores, CO 81323 <br />Phone Number: (970) 882 -7878 <br />Fax Number: (970) 882 -3888 <br />E -mail Address: caseymcclellan @msn.com Added <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />it below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclose <br />Cas <br />Signature of Co orat Officer, Owner, or Designee <br />Attachments: <br />I Map (with notes) <br />❑ Written report <br />❑ Other: <br />00401 signed b wunmw wn eu3 <br />Nathan A Barton �=w�. ,.a.�� -� E' - � <br />Da.: 3011.1313:33..3 2607 <br />