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R~C~9V~.®~-- <br />ANNUAL FEE and REPORT REQUEST <br />OCT 0 q 2002 <br />Division of Minerals an;7 Geology <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Colorado Lien Company <br />M-1985-038 <br />Rifle Quarry <br />September 26, 2002 <br />$688.00 (Due on or before your anniversary date) <br />Garfield <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I 16, 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 [he preceding year, new disturbances that are anticipated [o occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for [he beginning <br />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 sufftce for a written report. <br />Division records indicate the following petmit[ee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact Lecia Craft <br />Permittee Name: Colorado Lien Company <br />Address <br />Phone Number: <br />Fax Number: <br />P.O. Box 767 <br />Rapid City, SD 57709 <br />(605)342-7224 <br />(Qo5-3Q¢-17yFb <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 />Signa[ure~pf Corpora[ Of icer, Own , or Designee <br />lo~ilov <br />Date <br />M:~PERM ITN1ASTERD000 MENTSVN-AF-01 <br />