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filer <br /> <br /> ANNUAL FEE and REPORT REQUEST <br /> <br />PERMITTEE NAME: Sky Ute Sand & Gravel, LLC <br />PERMIT NO.: M-2003-037 ~/ <br />OPERATION NAME: Haldorson Sand and Gravel Mine <br />ANNNERSARY DATE: December 16, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Montrose <br />NOV 16 2001 <br />~ivisirsn of ~ecja~ation, <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 annual fee, a report and map showing the extent of current disturbances to affected land, <br />r _ 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 your 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. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous vear's map are necessarv. then no new map is repuired, 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: Kevin Hunt <br />Permittee Name: Sky Ute Sand & Gravel, LLC <br />Address: P.O. Box 3268 <br />Montrose, CO 81402 <br />Phone Number: (970) 249-6533 <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 />gna ure of or o • fficer, Owner, or Designee <br /> <br />Date ~T~~ <br />