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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COLIN'I'Y: <br />ANNUAL FEE and REPORT REQUEST <br />r~ Base Products <br />t/M-1994-053 <br />Base Product Gravel Pit 1 <br />September 13, 2006 <br />$688.00 (Due on or before your anniversary date) <br />Montrose <br />RECEIVED <br />~AUG 0 9 2006 <br />~iViSiOn of Reclamation, <br />Mining and Safety <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_annuaLfee,_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 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 anuual 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: Tony F. Appelhanz <br />Permittee Name: Base Products <br />Address: 62339 W. LaSalle Rd. <br /> Montrose, CO 81401 <br />Phone Number: (970) 249-3061 <br />Fax Number: <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 />Signah of Corp9 b Officer, Owner or Designee <br />~l-Lv-U~ <br />Date <br />