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Illlllllllllllll � <br /> ANNUAL FEE and REPORT REQUEST RECEIVED <br /> JAN 11 2001 <br /> PERMITTEE NAME: Superior S&G c/o Rio Grande Co Division of Minerals and Geology <br /> PERMIT NO.: ,�rll➢i�ifl ... <br /> OPERATION NAME: Superior S & G Pit <br /> ANNIVERSARY DATE: January 13,2001 <br /> ANNUAL FEE DUE: $688.00(Due on or before your anniversary date) <br /> COUNTY: Arapahoe <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 /> land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated 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 nary suffice for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact Brent W. Broekemeier <br /> Permittee Name: Superior S&G c/o Rio Grande Co <br /> Address: 201 Santa Fe Dr. <br /> Denver, CO 80223 <br /> Phone Number: (303) 825-221 1 <br /> Fax Number: (303) 629-0417 <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 <br /> enclosed. <br /> r <br /> Signature of Corporate Officer or Owner <br /> /Z %Z. Azwa <br /> Date <br /> M VERMITWASTERDOCU MENTSW-AF-01 <br />