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- M <br />~ ~~~~ <br />ANNiIAT. FF,F, and RFPt7RT RF.te7JFST ~-,; ', <br />n ~tl~ ~ 9 2ir~~ <br />PERMITTEE NAME: C//olorado Lien Company Jr/` <br />PERMIT NO.: t/D1-1978-093 `~ Qiuision of P:;i;._. . <br />OPERATION NAME: Newett Quarry <br />ANNNERSARY DATE: September 28, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: 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 cutrent disturbances to affec[ed-lan~]c, <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 ym~r revised written anm~al rennrt and anm~al report man to this form- Please note that an <br />adequately labeled map that clearly delineates and includes [he 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: Lecia Craft <br />Permittee Name: Colorado Lien Company <br />Address: P.O. Box 767 <br />ShL\l~ E~i Ct~~o-~l <br />P.~ Box ~-uo <br />Rapid City, SD 57709 <br />P-hone-Number: -(605) 342-7224.- - <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature of orporate Officer, Owner, or Designee <br />9 -~ -05 <br />Date <br />