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i~~ riuiiiiu~i~ iii <br />ANNUAL FEE and REPORT REQUEST <br />JAN 16 2002 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Pioneer Sand Company, Inc. <br />M-2000-080 <br />Pioneer Farm <br />January 23, 2002 <br />RECEIVED <br />OIYiSiOn of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Arapahoe <br />According [o C.R.S. 34-32.5-116 or C.R.S. 34-32-I 16, each year, on the anniversary date of [he 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 your revised written annual report and annual report map to this form. Please note that att <br />adequately laGeled map that clearly delineates mrd includes the above elements may sake for a written report. <br />Division records indicate the following permi[tee contact information. Please verify and make any necessary <br />changes: <br />Toa /f'RA/6 <br />Permittee Contact: 1Veync-Bramiey <br />Permittee Name: Pioneer Sand Company, Inc. <br />Address: 5000 Northpark Dr. <br />Colorado Springs. CO 80933 <br />Phone Number: (303) 340-1440 <br />Fax Number: (719) 599-8882 <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 />%~1t,~trG d G2.QO/-,.-L 4Jr1S !oM/o/rT.r'!~ O./ `/.rI79t,e~s, J. ~/7 A[ArJ ARe <br />CKIPRr.~7/y O/'!./ Fo2 M/„/,rG. H//'por/M?TdLy /O-?o RCROS C//// B/ M/-.~O/) <br />7!/is lv.~..%vG ydr,12, S - /o At!/,es 4li// <br />Sig lure f Corporal gf~ficer or Owner (j~ ToPSoiLr p ,~- S<'e D~/j - <br />ii-o~ _ <br />Dale <br />M 1P E R M I"I V.1 A STER DOC U M E NTSU1-A F-01 <br />