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<br />RE~~I\lED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Continental Materials Corporation <br />M-1977-376 <br />Canyon Dolomite Quarry <br />September 22, 2004 <br />$688.00 (Due on or before your anniversary date) <br />Fremont <br />SEP 1 7 2004 <br />fIN~S~hL ~, ;.;hmralc end G80108P <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-accamplished-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, tho dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attachynur revised written annnal renrnrt and annual rennrt map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may sufftce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: B.J. Fuller <br />Permittee Name: Continental Materials Corporation <br />Address: 444 E. Costilla <br />Colorado Springs, CO 80803 <br />Phone Number: (719) 485-0700 <br />Fax Number: (719) 633-2607 <br />~ETE M64GNt 1Z <br />(~laZy~s-a~oo <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 />Signature of Co orate Officer, Owner, or Designee <br />9-iL- oY <br />Date <br />