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MRR-30-2001 09:20 FROM:CDOT MP6IRLS LAB 3037579008 TI70248III'��IIIIIIIIII 017,011�9{//////_ <br /> 999 <br /> ANMJAL FEE and REPORT REOUEST 7l// <br /> RECEIVED <br /> PERMPfTEE NAME: Colorado Division of Highways APR 0 4 1001 <br /> PERMIT NO.: M-1979-155 <br /> OPERATION NAME: Dotsero Cinder Pit Division of Minerals and Geology <br /> ANNIVERSARY DATE: February 1,2001 <br /> ANNUAL FEE DUE: $281.00(Due on or before your anniversary date) <br /> COUNTY: Eagle <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 erased for the year, if any. <br /> Please attach your revised written annual resort and annual report map to tbls form. Please note that an <br /> adequately labeled map that clearly delineates and includes the above elements may suffice for a writren <br /> report. <br /> Division records indicate the following pormittee contact information. Please verify and make any necessary <br /> changes: <br /> Permitter Contact: Ilyess Ksouri <br /> PermitteeName: Colorado Division of Highways T6r6P�f��IU✓\_ <br /> Address: 4340 E. Louisiana Ave. <br /> Denver,CO 80222 [} / Q <br /> PhoneNumbcr: (303)757-9432 -75-7— -1Z-�O I <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 <br /> enclosed. <br /> - <br /> 1.� <br /> Signature of Corporate OfGccr or Owner <br /> Date <br /> M!WERJAnwASTRRD000A@NT5M.AF-U1 <br />