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999 <br /> ANNUAL FEE and REPORT REQUEST <br /> PERMITTEE NAME: Grand County RECEIVED <br /> PERMIT NO.: M-1977-256 MAR 0 9 2001 <br /> OPERATION NAME: Benson Pit Division of Minerals and Geology <br /> ANNIVERSARY DATE: March 23,2001 <br /> ANNUAL FEE DUE: $688.00(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 <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 activeioperations, 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. Please note that on <br /> adequately labeled n+ap that clearly delineates and includes the above elements may suffice for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Perm ittee Contact: M C. Branstetter <br /> Permittee Name: Grand County <br /> Address: 467 E. Topaz Ave. <br /> P.O. Box 9 <br /> Granby, CO 80446 <br /> Phone Number: (970) 887-2123 <br /> Fax Number: (970) 887-3168 <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 <br /> enclosed. <br /> Signature of Corporate Officer or Owner <br /> 3 -/14i <br /> Date <br /> M:IPERM ITNIASTERDOCUMEN'TSA4-AF-04 <br />