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2012 -03 -07 01:31 DRMS <br />rt ma ! tle fo <br />i ce • . b our ' w 'tten a � ual r rt I annual L,_ The Annual Report <br />& Fee requirement is not met until we have received the following components: fee. report, and associated <br />map• IIn new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previou year' man • neces sary, then no nett man is repaired_ 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 .twice for a written report. <br />Division records indicate the following permitter contact information. Please verify and make any necessary <br />changes: <br />Pennittce Contact: lientcm Jensen <br />Pennittee Name: Western Gravel, LLC <br />Address: P.O. 808 <br />Phone Number: <br />Fax Number: <br />Date <br />1 1UA I, IEEE sod REPORT REQUEST <br />PERM[TTEi NAME: Western Gravel, LLC <br />PERMIT NO.: M- 2008 -070 <br />OPERATION NAME: WRC Gravel Pit <br />ANNIVERSARY DATE: February 24, 2012 <br />ANNUAL, FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Rio Blanco <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 arc anticipated to occur <br />during the upcoming year, reclamation that will be performed during the wining year, the dates for the beginning <br />of active' operations, and the date active operations ceased for the year, if any. <br />auch 7' <br />Meeker, CO 81641 <br />(970) 878-5564 <br />9re — P7s- 55 - 6 <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 to . long with your written report and map. Annual Report instructions are enclosed. <br />• <br />gnature of Corpo 'Officer, Owner, or Designee <br />3038328106 » 1 970 878 5564 P 2/2 <br />1 <br />M <br />RE'CE'IVED <br />MAR 7 2 2012 <br />Division of Reclamation, <br />Mining & Safety <br />