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ANNUAL FEE and REPORT REOUEST <br />RECEIVED <br />PERMITTEE NAME: Weber Sand & Gravel, Inc. ? <br />PERMIT NO.: M-1995-056 ? ?S?P Z??q 111 <br />Division of Reclamation, <br />OPERATION NAME: Weber Pit No 2 Mining and Safety <br />ANNIVERSARY DATE: September 18, 2009 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Archuleta <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_&e_preceding_Xear.,._ne_wAisturbances 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 />man. 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 may 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: Andy Weber <br />Permittee Name: <br />Weber Sand & Gravel, Inc. <br />2980 E. Hwy. 160 <br />Address: <br />Phone Number: <br />Pagosa Springs, CO 81147-9741 <br />(970) 264-4568 <br />Fax Number: (970) 264-9089 <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 />4a;6L(hAh'V <br />Signature of rporate Officer, Owner, or Designee <br />?- Doi <br />Date