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ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Colorado Rose Red Corporation <br />M-1978-332 <br />Colorado Rose Red Pit <br />October 23, 2002 <br />$281.00 (Due on or before your anniversary date) <br />Larimer <br />RECEIVED <br />ocr o ~ 2002 <br />Division of Minerals an,1 Geology <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 />-sha11_submit_the_annual_fee,=a_report-and map_showing_the_extent=of_current_disturbances_to affected_land,-_ <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to 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 year, if any. <br />Please attach vour revised written annual report and annual report mau to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permit[ee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Daniel L Liesveld <br />Permittee Name: Colorado Rose Red Corporation <br />Address: 148 Cheyenne Ct. <br />Lyons, CO 80540 <br />Phone Number: (303) 823-6023 <br />Fax Number:. _ ~ _ ___ _ _ _.__ _ <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 />Signature o orporate Officer, Owner, or Designee <br />Date <br />M:~PERM ITMASTERDOCUMENTSVN-AF-01 <br />