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J <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ACA Products <br />M-1998-104 <br />Pine Ridge Pit <br />RECEIVED <br />APR 3 0 2003 <br />April 27, 2003 Division ~f Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Lake <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 />_- -- =sfia11 submit the annual:Fee; ~-report-and_map-showing~the extent-of-current_disturbances=to_ 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 your revised written annual rennrt and annual report main 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 tnake any necessary <br />changes: <br />Petmittee Contact: Chazles Murphy <br />Permittee Name: ACA Products <br />Address: P.O. Box 1887 <br />Phone Number: <br />Fax Number: <br />Buena Vista, CO 81211 <br />(719) 395-3790 <br />(719)395-3794 <br />~oN ~ou.ENBEC~ <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 />~~ <br />Signature of Co to Officer, Owner, or Designee <br />~I 1~ ~03 <br />Date <br />M:NERMITUv1ASTERD000MENTSUA-AF-01 <br />