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?* QT-r <br />ANNUAL FEE and REPORT REQUEST <br />F? t?'Vwv <br />PERMITTEE NAME: Grand Junction Pipe & Supply Co. <br />M-1998-105 "AUG 0 2 2010 <br />PERMIT NO.: / <br />!/ ? Divi?rn esr i?eci?n, <br />OPERATION NAME: Delta Paving Gravel Pit 6 mining and Suety <br />ANNIVERSARY DATE: August 6, 2010 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Delta <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 -o£_current- -disturbances to-affected land,- - <br />--- --reclamation-accomplished-to:?-date and.-duringAh"reced4*--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 may 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 may 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: Edward J. Settle <br />Permittee Name: Grand Junction Pipe & Supply Co. <br />Address: P.O. Box 1849 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4604 <br />Fax Number: (970) 243-6703 <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 orporate Officer, Owner, or. Designee - <br />7- 28-lam <br />Date