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<br />~~~~Pi <br />PERMTTTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNPJERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~C lorado Quarries, Inc. <br />//M-1987-027 <br />Hardship Lode Quarry <br />November 6, 2005 <br />rc d <br />RECEIVED <br />~NOV 1 0 20~ <br />.rQ Division of Minerals and Geology <br />$28I.00 (Due on or before your anniversary date) <br />Custer <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of_current disturbances_to affected land.-- _ <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach ymrr revised written anneal rennet and anneal regDrt main to this form- please note that an <br />adequately labeled map that clearly delineates and includes the above elements may sufface for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Pennittee Contact: Bill Tezak <br />Permittee Name: Colorado Quarries, Inc. <br />Address: -270 S. 15th St. <br />Canon City, CO 81212 <br />Phone Number: (719) 275-6894 <br />Fax Number: (719) 275-2131 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />~-~ <br />Signature of C orate Officer, Owner, or Designee <br />Date ~OCE FS$ ~G~ ~ ~ ~~ r S <br />~-~ ~ . <br />