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ANNiiAi. FF.F. and RF.Pt7RT RF~iiF.ST <br />RE <br />PERMITTEE NAME: Colorado Marble, L.L.Q. CE~VFp <br />A(lG <br />PERMIT NO.: M-1987-028 ~ ~ ZQQ6 <br />Divisio <br /> <br />OPERATION NAME: <br />Lily Mines n ar <br />Mining aRd Sa eYion <br /> <br />ANNNERSARY DATE; March 18, 2006 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COiJNTY: Chaffee <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 ,~uur revised written annnll rernrt and anm~al re~nrt maw to this form- Please note that an <br />adequately labeled map that clearly 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: Bill R. Addison <br />Permittee Name: Colorado Marble, L.L.C. <br />Address: 229 Industrial Park Rd NE <br />Cartersville, GA 30121 <br />Phone Number: (770) 607-3345 <br />S~L~i1 m us ~..+ira~6L [a. LLl. <br />A~+r-4- ,2d <br />/2a...,o-/ate CR S2o65 <br />Fax Number: (770) 607-3346 ~1~(. , b'GG 32F S'SGo ffrx 7GO 7PI T7L~ <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 />~ re of Corporate Officer, Owner, or Designee <br />~~ ~~~1~ <br />Date <br />