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<br />AN AL FEE and REPORT RE UEST <br />PERMITTEE NAME: v s Animas County <br />PERMIT NO.: 20-1998-011 <br />OPERATION NAME: Unwin Gravel Pit <br />ANNIVERSARY DATE: April 1, 2011 <br />4-0 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date, <br />COUNTY: Las Animas <br />RECEIVEC) <br />4PR 2 v 4": <br />Division of Reciamation, <br />Mining & Safety <br />44.- - <br />/b3gS <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning 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 <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous vear's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the 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: Phil Dorenkamp <br />Permittee Name: Las Animas County <br />Address: 2000 N. Linden Ave. <br />Trinidad, CO 81082 <br />Phone Number: <br />Fax Number: <br />(719) 846-4766 <br />(719) 846-0434 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or Mach it to this form along with your written report and map. Annual Report instructions are <br />, Owner, or Designee <br />SGT <br />Date <br />M:\PERMITVv ASTERDOCLTN ENTS\M-AF-04