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i~o <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANN[.IAL FEE DUE: <br />COUNTY: <br />Pioneer Sand Company, Inc. <br />M-2000-080 <br />Pioneer Farm <br />January 23,2006 <br />$688.00 (Due on or before your anniversary date) <br />Arapahoe <br />RECEIVEC <br />~aN t 2 Zoos <br />Oivis, ~ ,.,, ,,,,,; ~eoiagy <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 />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 anmval rennrt and anneal rennrt myt, to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffce 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: Pioneer Sand Company, Inc. <br />Address: P.O. Box 7650 <br />Colorado Springs, CO 80933 <br />Phone Number: (303) 340-1440 <br />Fax Number: (719) 599-8882 <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 />f~f/~ /~F-O H/~' ~%7~'k/S S' / % HIRES ,~„ /.,~~ ~a/ G~~4~ a i~tip %~F'so / [ ~.!> <br />Signat e ~o>~orate Offi~,ef, ~JCvner, or Designee <br />Date <br />