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~m~ <br />~~~~ <br />pNNIL~I. (•I?~, and R~P~OIRT R[``Ol1~ST <br />PERMITTEE NAME: Baculitc ~4csa LLC T' <br />PERMIT NO.: ~M-1997-Ill I <br />OPERATION NAME: 13aculitc Mesa Pit <br />ANNIVERSARY DATE: .Inly 9, 2005 <br />ANNUAL PEE DUB: $688.00 (flue nn or bc(ore ,your anniversary date) <br />COUNTY: Pueblo <br />~~~~~~r <br />S P ~ 2 2005 <br />7UDivisian of Minerals and Gaalap~; <br />According to C.R.S. 34-32.5-1 16 or C.R.S. 34-32-I I6, each year, nn the antiversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current dishrrhances to affected land, <br />reclamation accomplished to date and during the precaling year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will he performed during the coming year, the dates for the beginning <br />of active operations, and the state active operations ceased lilt the year, if any. <br />Plra~c attach your revised writ[ nr ann~sl_~narL,7ritL7nnll111 r ~nnrt map to this form. Plense note thnt an <br />ncleduntely (crbeled mop tlrnt elerrrly rlelinentee rmrl tnrlurle.r the nbnvc elements mqv sr ffrce for n nrltten report. <br />Division records indicate the following Permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Pred J. Orr <br />Permittee Name: I3aculite Mesa LLC <br />Address: 5040 Acoma <br />Denver, CO 80216-2010 <br />Phone Number: (303) 295-1216 <br />Pas Number: (303) 295-1256 <br />If you have additional comments and/or information that should he 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 />Officer, Owner, or Designee <br />Date <br />R7:`PERR11TA1ASTERf~CI )R1F.NTS`R7-AF-0I <br />