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-Alt <br />L ? <br />A FEE and RT REQUEST CCEIV <br />PERMITTEE NAME: ?APC Southern Construction Co., LLC <br />MAY 1320?? <br />PERMIT NO.: l/l?I-2002-118 lvi.sion of Reclamation, <br />OPERATION NAME: Velarde Pit -01 Mln;rg and Salty <br />ANNIVERSARY DATE: June 9, 2011 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Huerfano <br />ok- <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-accornplished to -date and-during the preceding year, neW- disturbances that aantcipated fo 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 chances to <br />the previous year's may 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: James MacDonald <br />Permittee Name: APC Southern Construction Co., LLC <br />Address: 14802 W 44th Avenue <br />Golden, CO 80403 <br />Phone Number: CF.PR.telephone_number <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 />S ature of Corporate Offier, Owner, or Designee <br />-51-411 <br />Date <br />