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PERMITTEE NAME: /Richard Fryrear t <br />PERMIT NO.: 1(1- 1998 -071 RECEIVED <br />OPERATION NAME: Fryrear Gravel Pit 1 46‘ , 0 8 2011 <br />ANNIVERSARY DATE: November 6, 2011 Oil/talon of Reclamation, <br />ANNUAL FEE DUE: $5791.00 (Due on or before your anniversary dat41 lning & Safety <br />COUNTY: Yuma <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 />reclamationon accompCslied fo Bate inif during the-preceding 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 year's map are necessary, 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: Richard Fryrear <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Richard Fryrear <br />8085 CR 13 <br />Haxtun, CO 80731 <br />(970) 774-6551 <br />Signature of Corpora fficer, Owner, or Designee <br />/ /gyp// <br />Dat <br />dr- <br />ANNu AL FEE and ORT REQUEST <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 />