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t1AY-09-02 14:26 FROM-Colorado Division of Minerals & Gaolasy <br />+13036663567 <br />RECEIVED <br />PE1tMTTTEE NAME: <br />PE)tMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and i(LEPORT REQUEST <br />T-569 P.003/003 F-139 <br />MAY i 3 2002 <br />11~Tonarch Stone Company <br />M-1991-037 <br />Katuska Pit <br />May 3, 2002 <br />$281.00 (Due on or before your anniversary date) <br />Park <br />Oivislon of Minerals and Geology <br />According to C.R.S. 3432.5-116 or C.R.S, 3432-116, 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 />reclamarion accomplished to date and daring the preceding year, new disturbances that aze anticipated to occur <br />during the upcoming year, reclamation that will be performed during the comin; year, the dates for Che beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annnal report and annual report man to this form. Please note that an <br />adequately labeled map that clearly delineates and includes zhe above elemenn ,nay suffice far a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Petmittee Contact: Anthony I. Kirnmiclc <br />Permittee Name: Monarch Stone Company <br />Address: 6260 S. Vivian St. <br />1_ittlemn, CO 80127 <br />Phone Number: <br />Pax Number: <br />(303)933-9657 <br />(303)933-2370 <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 trap. Annual Report instructions are enclosed. <br />~ r <br />Sia ature of Corporate Officer or Owner <br />S, ~ ~~ o <br />Date <br /> <br />M:IPERMmMgSTER000~M ENISWI-wF01 <br />