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PERMITTEE NAME: <br />PERMIT NO.: <br />~lQ,p~ <br />AN A~FEE and REPORT REQUEST <br />Schmidt Construction Company <br />M-1989-065 <br />RECEIVED <br />~1PR 2,6 2001 <br />OPERATION NAME: Winkler Light Aggregate Quarry Division of Reclamation, <br />c./ Mining and Safety <br />ANNIVERSARY DATE: Apri126, 2007 <br />ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date) <br />COUNTY: Douglas <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 upcomh~g-year, reclamati°-~ "'^' ~~ '~~ h ~~+**+_~1!~r nng.th~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 />mau. If no new disturbances or reclamation have occurred durinc the previous year and no new chances 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 since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />PermitteeContact: Scott Davis <br />Permittee Name: Schmidt Construction Company <br />Address: 2635 Delta Dr. <br />- - --Colorado Springs,-('.0-809iO-- <br />Phone Number: <br />Fax Number: <br />(719)392-4207 <br />(719)392-4245 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below o attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signa a of Corporate Officer, Owner, or Designee <br />~~~" ~7~ <br />Date <br />