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FROM :CCMD <br />,. <br />FR7S N0, :676-3172 <br />Dec. 08 2005 10:39RM P3 <br />RECEIVED <br />DEC t 2 2005 <br />Division of Minerals and Geology <br />P[12M1'1"I'8F. NAME: <br />PERMTI' NU.: <br />UP1,;1tA'f10N NAME: <br />ANNIVERSARY DATE: <br />ANNI7Ai. C}L Dl1E: <br />C'0}INTY; <br />Colorado C9ty Metropolitau District <br />M•1979-158 <br />Mnontain Shadows 1'k <br />December Z0, 2005 <br />$688.00 {Duo on or before your anniversary, date) <br />Pochlo <br />According to C.K.S. 34-32.5-116 Or C:,R.S. 34-92-11b, each year, On the anniversary date of the permit, un <br />operator shall submit the annual fee, a report and map slwwing the extent of cturent disturbances to affected <br />land, reclamation accomplished to date and dw'ing the preceding year, row disturbances that are anticipated to <br />Occur during the upcoming year, reclamation that will be performed during the coming year, ltu: dales 1'Or the <br />beginning of active operations, and the datr; active opxrations ccraux{ for the year, if any. <br />]'least attach your revised Mriffep yqn +, r al re,Pnrt sod annual report ntan t. thtyfnrm- /'(ea.te note tkat art <br />adequately labeled map that clearly delrtreates and includes the ahnve elements may since far a written <br />repr~rt. <br />Division records indicate the following pernuttee contact utfrnmalion. Ylea+e verify dnS make any ncocssary <br />changes: <br />pv~'mitleeCOn[act: TrankMain <br />Fermittee Name: C:olonulo City Mclropolilan District <br />Address: 4497 Bent Brothers Blvd <br />P. O. Box 19390 <br />Colorado City, CO 81019 <br />Phone Numlx;r: ('719) 676-3]96 <br />h'ax Number; {719) b76-3172 <br />If you lutvc arLlitional comments and/or information [hat shmald he provided t0 the Division, please provide it <br />belmv or attach it to this farm along wiQ: your written rcpori and map. Annual RcprnY instructions arc <br />enclosed. <br />r <br />r Si ur oijia to Officer, Owner, Or DCSignee <br />_~._G-a.... .__. <br />_. <br />Date <br />Mil'aNM1TMASTIIRDbQRrIeNTSIAS-APfiI <br />