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~~~ <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 />v M-1977-168 <br />Marrs Memorials <br />November 30, 2006 <br />~ZZ <br />Ib ~~-c~' <br />RECEI!/ED <br />/~ ocT 2 o z~tis <br />Division of Reclamation, <br />Mining and Safety <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 extent of current disturbances to affected Land, <br />- reclamation accomplislied~date arid-during the preceding year; new disl~ances that are anhoipafea-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 vour revised written annual report and annual report roan to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />man. If no new disturbances or reclamation have occurred during the previous vear and no new chanties to <br />the previous year's map are necessary. then no new mau is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Bil] 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 />ignature of Ca orate Officer, Owner, or Designee <br />1'~~- t~ ~ <br />Date ` ~~?- ~G/! S ~~~ <br />d GJ~~'/l~•t'S 1g ~ ~~s ~f <br />// <br />