2001-11-14_REPORT - M1977168

• Permit No: M1977168
• IBM Index Class Name: Report
• Doc Date: 11/14/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Colorado Quarries, Inc.
M-1977-168
Marrs Memorials
November 30, 2001
$281.00 (Due on or before your anniversary date)
Fremont
NOV 14 ?001
Dtrision of Minerals end Geology
According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-I 16, each year, on the anniversary date of the permit, an operator
shall submit the annual fee, a report and map showing [he extent of current disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated [o occur
during the upcoming year, reclamation [hat will be performed during the coming year, the dates for the beginning
of-active operations,-and-the da[eacti.ve operations ceased for the year, if any. _ _ _
Please attach your revised written annual report and annual report map to this form. Plense note that art
adequately lnbeled rnnp that clearly delineates and includes the above elemerus may sake for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee ContacC Bill Tezak
Permittee Name: Colorado Quarries, Inc.
Address: 270 S. 15th St.
Canon City, CO 81212
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
~~
Signature of Corporate Officer or Owner
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