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, <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />,P,F *- Qpr <br />ANNUAL FEE and REPORT REOUEST <br />W/ Oldcastle SW Group, Inc. d.b.a. B & B Excavating <br />M-1997-026 <br />Carol Ann Pit <br />RECEOVcm <br />t--` AUG 2 ` 2009 <br />35, Division of Reclamation, <br />Mining and Safat?t <br />September 8, 2009 <br />$791.00 (Due on or before your anniversary date) <br />Eagle <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, 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 year'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: Jason Burkey <br />Permittee Name: Oldcastle SW Group, Inc. d.b.a. B & B Excavating <br />Address: P.O. Box 4870 <br />Eagle, CO 81631-4870 <br />Phone Number: (970) 328-1734 <br />Fax Number: (970) 328-1735 <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 />Signature of rporate Office wner, or Designee <br />Q <br />Date