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ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Fruita Development LLC COVE) <br />PERMIT NO.: M-2002-111 OCT 2 1 2010 <br />OPERATION NAME: Gilsonite Gravel Pit <br />anti SO* <br />ANNIVERSARY DATE: October 21, 2010 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <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 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 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: <br />IDou?la s Lo <br />Permittee Name: Fruita Development LLC <br />Address: 11990 San VicenteBoulevard, Suite 200 <br />Las Angeles, CA 90049 <br />Phone Number: VTO"96.996* <br />3\0 - 2o(- R89'o <br />Fax Number: 2ft&-9 8! '0" :?>10 - 20(o - q so <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 />a 'Dourfl&5 row n <br />Signature of Corporate Officer, Owner, or ignee <br />Sepk?ber H , ;-oto <br />Date