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~1AR-6.-2884 13:40 FROM:CDOT MATERIALS LAB 3fl3-757-9flfl8 T0:97H2487292 P,HH9~H17 <br />ANNUAL FEE and REPORT REQUEST ~~~ ~ 6 ° '° ~°~ <br />PERMITTEE NAME: Colorado Division of Highways MAR 31 2004 <br />PERMIT NO.: M-179-155 Division of Minerais & CeoloAY <br />OPERATION NAME: Dotscro Cinder Pit <br />ANNIVERSARY DATE: February 1, 2004 <br />ANNUAL FEE .DLIE: 8281.00 (Doe on or before yonr xnnivorsary date) <br />COUNTY: Eagle <br />According to C.R.S. 34-32.5-11G or C.RS, 3A-32-].16, each year, an the anniversary date of the permit, an <br />operator eha11 submit the annual fee, a report and map showing the extent of current disturbatues to affected <br />land, reclamation accomplished to date and'during the prcccdi'ng year, new disturbances that are anticipated to <br />occur dosing 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, i,f any. <br />Please atfoch vour revised written. annnal reonrt and annnal report mxn to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the 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: Eric Prieve <br />Permittee Name: Colorado Aivision of Highways <br />Address: 4340 E. Louisiana Ave. <br />Denver, CO 80222 <br />Phone Number: <br />Fax Num6n,: <br />(303)757-92b9 <br />If you ha.vc additiaaal comments and/or inforxnatinn that should be provided to the Division, please provide it <br />below or attach it to this form along with yots written report and map. Annual Report instructions are enclosed. <br />Signatwe of Corporate Officer or Owner <br />'3-Zy-o`/ <br />Date <br />N'o w.o~'~~ ~{w~oJ~2f9 <br />i.~ 'Z o 0 3 <br />