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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Colorado Lime Company <br />M-2000-098 <br />Monarch Quarry <br />January 15, 2004 <br />'1AN 12 2004 <br />OiVision of Mr. <br />$688.00 (Due on or before your anniversary date) <br />Chaffee ~~V\1 <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 'sh`owing the ezten't of current disturbances [o'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 ynnr revised written anneal retort and anneal re~nrt main 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 permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Johnney G. Bowers <br />Permittee Name: Colorado Lime Company <br />Tollie Smith <br />Address: 13800 Montfort Dr., Ste. 330 <br />Dallas, TX 75240 Salida, CO 81201 <br />Phone Number: (972)991-8400 ~tn_S~o_as~6 <br />Fax Number: (972)385-1340 719-549-7979519-7~7~ <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 />~~ <br />Signature Officer, Owner, or Designee <br />//9 /a <br />Date <br />M:\PERMIT\MASTERDOCUM ENTSVN-AF-01 <br />