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rut ~/L <br />;a-2s-G>'o <br />g~~ <br /> r/ ANNUAL FEE and REPORT REQUEST <br /> R <br />~ <br />PERMITTEE NAME: ~ Parkerson Construction Co. ~+~~ ~ D <br />PERMIT NO ~M <br />1978 <br />323 ACT <br />.: - <br />- ~ <br />~ <br />OPERATION NAME: Woodring Pit ~ p <br />MSnin9 a d 3a <br /> <br />ANNIVERSARY DATE: <br />November 22, 2006 n, <br />y <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <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 dist_urb_ances to affected_land,_ _ <br />reclamation accomplished to date and during the 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 vour revised written annual reuort and annual report maa 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 arevious veer and no new chances to <br />the arevious year's maa are necessary, then no new moo 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: Alan Parkerson <br />Permittee Name: Parkerson Construction Co. <br />Address: 710 S. 15th St. <br />Grand Junction, CO 81501 <br />Phone Number: (970) 242-8134 <br />Fax Number: (470) 242-8977 <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 />ignature of Corporate Officer, Owner, or esignee <br />/C/. ~~ <br />Date br <br />