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® oii oiooiooiooooo oio ~- <br />PERMTI'TEE NAME: Colorado Quarries Inc <br />PERMIT NO.: M-77-144 ~~C~(~/~® <br />OPERATION NAME: Mica Lode Ih~ it 2 t1 jc~c~~ <br />ANNNERSARY DATE: November 30,1999 r•r c~ ~'iiin8rag g Geology <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $550.00 <br />COUNTY: Fremont <br />According to C.R.S. 34-32.5-116(3)(a), 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 <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for the year, <br />if any. <br />Please attach your revised annual report maa and written report to this annual report. Please <br />note that nn adequately labeled map that clearly delineates and includes the above elements may <br />suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: r (( (~ 2, JI-~C <br />C c~ ~~~ ~~~_~~:~ ~~ <br />Company: ("d/ SAC/D ~JR+/P~~/t'~ ~'~- <br />Phone No.: f7/fi )~ 75~ ~%~~` <br />Fax No.: l~i%)d7 y..(r ` 07/ 3 / <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />Signature of C rporate Officer, or Owner Date <br />~o /(lew ois7~vi'tiA~~P- - C°~PvSliiRy ~~~v~-(~un~sos .¢hd ~S/o~~~Y~ <br />/NSTRUCTIONS ON BACFC <br />