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~ ~rr~1~ <br />o~ <br />a <br />~ ANNUAL FEE and REPORT REQUEST <br />J <br />"'~ <br />PERMTI'TEE NAME: !/ Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />PERMIT NO.: vM-1979-205 ~RECE I VED <br />OPERATION NAME: ~ ambers Pit <br />ANNNERSARY DATE: August 15, 2006 [/A~~ ~ 4 2~~6 <br />ANNUAL FEE DUE: $685.00 (Due on or before your anniversary date) Division of Reclamation, <br />Mining and Safety <br />COUNTY: Garfield <br />According to C.R.S. 34-32.5-116 or C.R.5. 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 accomplislied'to date arid-during the preceding "year,-new distaitiances"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 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 (All are required regardless of the level of disturbance or absence of disturbance during the previous <br />year). Please note that an adequately labeled map that clearly delineates and includes the above elements may <br />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: Brent Kerr <br />Permittee Name: Oldcastle SW Group, <br />Address: <br />Phone Number: <br />P.O. Box 3609 <br />Grand Junction, CO 81502 <br />(970)243-4900 <br />Fax Number: <br />Inc. dba United Companies of Mesa County <br />If you have additional comments andlor 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 />Signature of Corporate Officer, Owner, or Designee <br />Date <br />