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_~~ - .s, <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br /> <br />ANNUAL FEE and REPORT REQUEST <br />Colorado City Metropolitan District <br />M-1979-158 <br />Mountain Shadows Pit <br />December 20, 2002 <br />RECEIVED <br />DEC 18 2002 <br />Division o}Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Pueblo <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />_ -!a=.:c!-reclamation-accemplished to date-and-Suring :h~precedrng-year~ew-disturbances-that-arc-anticpated to- - <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following pernrit[ee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Frank Main <br />Permittee Name: Colorado City Metropolitan District <br />Address: 4497 Bent Brothers Blvd <br /> P.O. Box 19390 <br /> Colorado Springs, CO 81019 <br />Phone Number: (719) 676-3396 <br />Fax Number: (719) 676-3172- <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 inswctions are <br />enclosed. <br />t - <br />~--- ' [- <br />Si at tre of Corporat Officer, Owner, or Designee <br />~a- i6-~ooZ <br />Date <br />M:~PERMITU~tASTERDOCUMENTSVvI-AF-00 <br />