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:~ <br />.~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />l~~ 1, , <br />~~~~ <br />ANNTiAT. FF.F, and RF,PnRT R,F~t7UiTF~ST <br />R E Monks Construction Co. "p' <br />,~M-1983-193 <br />Monks Plant No 1 <br />July 29, 2004 <br />RECEIVE® <br />~/AUG 2 3 2005 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />El Paso <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 zffected 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 ~nur revised written anneal rennet and anneal re nn rf m,~ to this form. Please note that an <br />adequately labeled reap 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: Dennis Good <br />Permittee Name: R E Monks Construction Co. <br />Address: P.O. Box 25579 <br />Colorado Springs, CO 80936 <br />Phone Number: (719) 495-3621 <br />Fax Number: (719)495-1281 <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 Corp~ra Of icer, Owner, or Designee <br />Date <br /> <br />