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~A ~ ~ R~-~ <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Webster Sand & Gravel ~ ~~~~'~~® <br />PERMIT NO.: M-1981-235 <br />APR 3 0 2000 / <br />OPERATION NAME: West Tennessee Division of Reclamation <br />ANNIVERSARY DATE: Apri122, 2008 Mining and Safety <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Lake <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 />--- ____ reclamation accomptishedito 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 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 durinE the previous year and no new changes to <br />the previous vear's map are necessary, then no new map 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: Daryl R. Webster <br />Permittee Name: Webster Sand & Gravel <br />Address: P.O. Box 1834 <br />Colleyville, TX 76034-1834 <br />Phone Number: (719) 486-0427 <br />Fax Number: (719) 486-0427 <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 />Signa a of orate Officer, Owner, or Designee <br />oy~_1~-vim <br />Date <br />