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. I ~J <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Colorado Quarries, Inc. <br />M-1992-058 <br />Mica White <br />August 5, 2002 <br />RECEIVED <br />JUL 1 ~ 2002 <br />Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Fremont <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_exten[_of current_ disturbances to affected land, _ _ <br />reclamation accomplished to date and during the preceding yeaz, 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 an <br />adequately labeled map that clearly delineates and includes the above elements may suffice 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 Tezak <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 Report instructions aze enclosed. <br />Signature o orporate Officer or Owner <br />~- llo_Q ~ <br />Date <br />s. ~ ~- d.,le. p /t v c.~s s <br />ft~l ~(ti /3~~, nt , ~U13'c~ <br />rl'l~.u e ~~ b ~~ ~ I ~„`~ ~ s its J/ <br />M:IPERMITMASTERDOCUMEN7SV.I-AF-01 <br />