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s <br />[ ~. <br />4VVI' U F'F'F' •~nd RF•1'OR'I' ItM'Ol F'S'I' <br />RECEIVED <br />PF:I(;1111 I LI• N:\~btli: ~ Schmidt ('onstruction ('ompany MAR 11 ?C(~ <br />Ph It ~n r vO.: ~>!-19xx-o44 <br />O~JIS L'J 11 ti to [l.: `, nil:; :~. <br />O1'1•.R.4IlOV 1\:~ti11.: ('oal ('reek Resourecs '''fir <br />:~\VI\'IiRSARY D:11 I,: Dlarch 28. 2011h <br />;~K\t':\I, fla I)1 I:: ~68R.00 (Uue on or before your anniversary datcl <br />('(ri iNl'Y': :lrapahoe <br />according to ('.It.S. 34-32.5-I lG or ('.R.S. ?4-?2-I I V, each year, on the anniccr>ary dote of the lxrntit, an operator <br />shall submit the annual fie, a report :md map showing the cstcnt of cumnt Jisturbanccs w afl'ccteJ land, <br />nclunrnum accomplished to d;NC and during the prcceehng year, nea dtsurrhanccs that arc anucgtatrd dr occur <br />during the up.nming ycv. rcclamanun that ~~ill be prtfurntcd during the aanntg year. the dates lire Ihr hcgutning <br />of achcc upcr:rti~ms. and the date arose upcr:ourm cca.cd ti+r the ~ru', it :u». <br />Igerr.e~tmch wmr rccived ~rrittcn our r~l report an 1 annn.l r~~>,nrt m.p to thiv form 1'Ir'usr rd,(e• flral an <br />~nlrrrn~urfr hrh,drd rrrdp [lure rlr~trR Jr•ltnr~r4•r ,end rrrrGrdra' tHr uhnrr e•lrmrrne mar s+r(lirr,lu~.r tvritren rt jrurr. <br />Dtvisum records indicate the liillorvtng permiltee cxmtuct ntfornration. Please verity and ntnke any necessary <br />changes: <br />Prrnutteel'ontact: Scott I)avts <br />I'ernnttee \anu: Schmidt Construction Company <br />aJJress: 2635 Iklta Dr. <br />(blunido Spnngs, ('(.) 511910 <br />Phone Numlxr: (719) 392-1207 <br />l~as Number. 1'191 392-.1245 - <br />11• you have aJihnonal comments and:'or information (hat should tK: provided to the Division. please proviJc it <br />below or attach tt to this linen aong with your written report rand ntap. Annual Kc}x~rt instnrcuons an enclosed. <br />/ <br />Signuhtre of ('o4~f)fliccr. Uwncr, or Designee <br />Dat~ ~~ ~ <br />