2006-10-20_REPORT - M1987116

• Permit No: M1987116
• IBM Index Class Name: Report
• Doc Date: 10/20/2006
• Doc Name: Annual Fee/Report/Map
• From: Colorado Quarries, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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i/ ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME: t//Colorado Quarries, Inc.
PERMIT NO.: V M-1987-116
OPERATION NAME: Siskin
ANNNERSARY DATE: November 2, 2006
ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date)
COUNTY: Custer
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,,~~OCT 2 0 2006
Division of Reclamation,
Mining and Safety
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
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
-`-'reetarttation'accomplished-tu-date and during the preceding year,-new disturbances tha£are anticipated"to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual reuort and annual resort maa to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, resort, and associated
maa. If no new disturbances or reclamation have occurred during the previous year and no new changes to
the previous year's man are necessary, then no new map is required. provided that the Operator shall state
this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the
above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Pennittee Contact: Bill Tezak
Permittee Name: Colorado Quarries, Inc.
Address: 270 S. 15th St.
Canon City, CO 81212
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
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Signature of Co rate Officer, Owner, or Designee
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Date
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