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~~ <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-1977-057 <br />Fedinec Pit <br />November 22, 2004 <br /> <br /> <br />ocr c ~ 2ooa <br />CSvisia., r i4.::.-,sis @. GeoloBY <br />$281.00 (Due on or before your anniversary date) <br />Moffat <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-I 16, each year, on the anniversary date of the permit, an operator <br />"shall submit, thc-annual- fee; areport-and-map-showing-the .extent- occurrent disturbances-te-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 ynnr revised written anneal report and anmial reRprt m 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: Joe Kraig <br />Permittee Name: Pioneer Sand Company, Inc. <br />Address: P.O. Box 7650 <br />Colorado Springs, CO 80933 <br />Phone Number: (719) 599-8100 <br />Fax Number: (719) 593-0167 <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 />Signa of C ~ orate Of~fi caner, or Designee <br />Date <br />