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O& <br />ANNUAL FEE an ORT REQUEST <br />PERMITTEE NAME: 17 Rio Grande Company <br />PERMIT NO.: VM-1979-189 <br />OPERATION NAME: Rio Grande Sand Pit S-4 <br />ANNNERSARY DATE: January 13, 2010 <br />IP <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Arapahoe <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-Iann , <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 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 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: Dennis Sandusky <br />Permittee Name: Rio Grande Company <br />Address: 201-Santa Fe Dr. - -- <br />Denver, CO 80223 <br />Phone Number: <br />Fax Number <br />(303) 825-2211 <br />(303) 575-0040 <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 />ignature of Corporate Officer, Owner, or Designee <br />REC1E <br />SAN 19 2010 <br />Date <br />oft & d*