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<br /> RECF11iED <br /> /~ T <br />~~ ~ V` P l '~~ 25 2007 <br /> ANNUAL FEE and REPORT REQUEST Olvlsion of Recla <br /> mation, <br />Mining and Safet <br /> <br />PERMITTEE NAME: <br />~ Colorado Quarries Inc y <br />PERMIT NO.: ~I-1987-026 <br />OPERATION NAME: Black Obsidian <br />ANNNERSARY DATE: November 6, 2007 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: 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 />~seclamation~ccomplished_to_date_anrt ~lur;ng_the preceding ear, ne~disturUances_that.aze anticipatedso_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 yeaz, if any. <br />Please attach your revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, resort, and associated <br />maa. If no new disturbances or reclamation have occurred durinc the previous vear and no new chances to <br />the urevious year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report, <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee 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 nd/or information that should be provided to the Division, please provide it <br />below or attach it to this form al ng with your written report and map. Annual Report instructions are enclosed. <br />Date <br />Hauling out of site only activity at pit this year <br />