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J <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNLIAL FEE DUE: <br />COUNTY: <br />Colorado Quarries, Inc. <br />M-1992-058 <br />Mica White <br />August 5, 2003 <br />$281.00 (Due on or before your anniversary date) <br />Fremont <br />RECEIVED <br />AUG 0) 2003 <br />llirision ~f Minerals and Geolo~~ <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 />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 anneal report m ~n 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: Bill Te7ak <br />Permittee Name: Colorado Quarries, Inc. <br />Address: 270 S. 15th St. <br />Canon City, CO 81212 <br />Phone Number: (719) 275-6894 <br />Fax Number: (719) 275-2131 <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 Repor[ instructions are enclosed. <br />S azure of Co rate Officer, Owner, or Designee <br />~. y-o.~ <br />r,1 Date ~ ~L~iiG~i7~' ~l / ' `~ yam', ~, / r~ • /"!~ /v~~ (. i/ /y~L/6~ <br />- `~(,`i Pf~~G4 <br />M:~PERM INNASTERDOCUM ENTSVN-AF-01 <br /> <br />