2007-04-23_REPORT - M1987028

• Permit No: M1987028
• IBM Index Class Name: Report
• Doc Date: 4/23/2007
• Doc Name: Annual Fee/Report/Map
• From: Colorado Marble, L.L.C.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO,:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
n i~
ANI~~FEE and >2EPORT REQUEST
Colorado Marble, L.L.C.
M-1987-028
Lily Mines
March 18, 2007
R R 23101
p w~ ~~n9 a d sa boo
$$281.00 (Due on or before your anniversary date)
Chaffee
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
shall- submit-the annual- fee,-a -report and map showing the extent of-current disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming yeaz, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
man. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to
the previous year's map are necessary, then no new map is required, provided that the Operator shall state
this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the
above elements may suffice for a written report.
Division records indicate the following permittee contact information, Please verify and make any necessary
changes:
Permittee Contact: Robert E. Holloway
Permittee Name: Colorado Marble, L.L.C.
Address: 18402 Dos Picos Park Road
Ramona, CA 92065
Phone Number: [phone]
Fax Number: [phone]

If you have additional comments and/or information that should be provided to the Division, please provide it
below or attac/h it to this form along/with your written report and map. Annua~loRepo/rJtninstructions are enclosed.
Signature of Corpor e Officer, Owner, or Designee
~/~/off
Date