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,p?- ir- Ur- <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Parkerson Construction, Inc. f/ RECEIVED <br />PERMIT NO.: M-1987-178 JAN[ 3 206,; <br />OPERATION NAME: 31 Road Pit Division of Reclamation, V <br />ANNIVERSARY DATE: February 12, 2009 Mining and Safety <br />ANNUAL FEE DUE: $791.00 (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 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,-renamation that will be performed during the coming year, the dates fop 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 man to this form The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />mau. If no new disturbances or reclamation have occurred durin the revious ear and no new chap es to <br />the previous year's man 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: Alan Parkerson <br />Permittee Name: Parkerson Construction, Inc. <br />Address: 710 S. 15th St <br />Grand Junction, CO 81501 <br />Phone Number: <br />Fax Number: <br />(970) 242-8134 <br />(970) 242-8977 <br />If you have additional co ents and/or information that should be provided to the Division, please provide it <br />below or attach it to thi o along with your written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />i/,L/ <br />Dat