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./J <br />1" - <br /> <br />OCT i 2 2004 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Colorado Rose Red Corporation <br />M-19'78-332 <br />Colorado Rose Red Pit <br />October 23, 2004 <br />$281.00 (Due on or before your anniversary date) <br />Larimer <br />,~: s., Decte9Y <br />Division o{ P?~+~ <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 />_ _reclamationaccemp'~~'~~-totiate-and ~n;ing the-preceding-pear n~disturbances that are antrc~pate tom <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 ynnr revised written anneal rennrt and anm~al rennrt main to this form Please note that an <br />adequately labeled map that clearly delineates and includes the 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 />Permittee Contact: Daniel J. Liesveld <br />Permittee Name: Colorado Rose Red Corporation <br />Address: 148 Cheyenne Ct. <br />Phone Number: <br />Fax Number: <br />Lyons, CO 80540 <br />(303)823-6023 <br />If you have additional comments and/or infotmation 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 />r10 Lt~IJtlfhF NAVi~ Br<E~1 mA~P~ <br />,~~~~ir~rlf' <br />Signature Corporate Officer, Owner, or Designee <br />/0-~-~y <br />Date <br />~ T~'1c- (~tlA'R.RY T~tS `t!frAR+ (3~latlg~ <br />O ~ T}}(G ~ I~ l tJ Pa~'i~ , 1J0 ptlfY NO '1'-~S~ <br />~'~ tCw4 LA~N1Tf LO W PIFT~ I W ~ A~2E_ <br />°~~n~4 I~Z PROflJVnoN u,li,-W, No <br />PR~oat~T, ~AP,r TImE WORK t5 r~-t_ <br />W'~ 14A~Ifc PRoc/IDI//h STD/ Foe <br />Lo1.ORdDD OIJI-'C. 'CHI UAFTA COMt'R14liT <br />is <br />4~CIU_INtt MY iNDJr7TeY. p,,, <br />out GtT~ <br />L~IA1A <br />