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<br />ANNT1Ai, FF,F, and RF.Pt7RT RF.OTTF.ST <br />f :, i . i,-~.~ <br />PERMITTEE NAME: Raymond F. & Robert W. Dellacroc <br />PERMIT NO.: M-1993-050 <br />OPERATION NAME: Dellacroce Pit <br />ANNIVERSARY DATE: February 22, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: 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 affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />- - -- -durng-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 ~nnr revised written annual ren~nrt and anneal report m yn 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: Raymond F. & Robert W. Dellacroc <br />Address: Pioneer Sand Co., Inc. <br />P.O. Box 7650 <br />Colorado Springs, CO 80903 <br />Phone Number: (719) 599-8100 <br />Fax Number: (7l9) 599-5317 <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 Corporate Officer, Owner, or Designee <br />~~,s/oyf <br />Date <br />