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<br />: -r <br />A AL FEE and REP RT REQUEST <br />PERMITTEE NAME: Pioneer Sand Company, Inc. <br />PERMIT NO.: ? M_2003-016 AUG 312010 <br />OPERATION NAME: Heit Sand and Gravel Mine Division of &ecla a °n' <br />wining <br />ANNIVERSARY DATE: September 27, 2010 Min <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Weld <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 ooining year, the dates for the beginning of active operations, and the date active operations ceased for the <br /> 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: Joe Kraig <br />Permittee Name: Pioneer Sand Company, Inc. <br />Address: P.O. Box 7650 <br />Colorado Springs, CO 80933 <br />Phone Number: (719) 599-8100 <br />Fax Number: <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 />r1-1,C epa4-T?' SNP S/`?o4//.,/G S i°l?sT ??-A/?J ??,?%.?G /tc7'aI2. /S fr1 c/f??,p <br />Signature oepor fficer, n , or Designee <br />9 /3a <br />Date