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PERMITTEE NAME: 41 BK Construction, Inc. <br />PERMIT NO.: I -1990 -106 <br />OPERATION NAME: RBK Pit No. 30 <br />ANNIVERSARY DATE: October 16, 2011 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Pueblo <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 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: Ronda Neumeister <br />Permittee Name: RBK Construction, Inc. <br />Address: P.O. Box 376 <br />//af►// _ <br />Signature of orp ate O i <br />AA% <br />Date <br />Rye, CO 81069 <br />Phone Number: (719) 489 -3385 <br />Fax Number: (719) 489 -2268 <br />>eld <br />ANNUAL FEE and REPORT REQUEST <br />er, or Designee <br />l i - <br />iistgivitp <br />OCT 12 ZQ11 <br />DIvIuIon of ReI@ma Qn• <br />MInIno & 89feIy <br />If you i ave : dditional comments and /or information that should be provided to the Division, please provide it <br />below •r . ach it to this form along with your wri j en report and map. Annual Report instructions are enclosed. <br />