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<br /> <br />Notice of Intent to Continue Mining Operations <br />112 Annual Report <br /> <br />Permittee Name: Centennial Materials, Inc. • <br />Permit No: M-76-009HR --_•,~ ~ ~: ''~ =~~,u <br />Operation Name: Menzer Ouarry <br />Anniversary Date: 12/31/90 ,ter <br />Total: b350.00 (Due on your Anniversary Date) <br />Please return this form with your completed Annual Report, map, and a check <br />or money order for annual flees due, payable to the Colorado Mined Land <br />Reclamation Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203. <br />ANNUAL REPORT: <br />See Attached <br />Signature: <br />Please list current address and phone number below: <br />Please type or print <br />Date: // - Z,~' -9°~ <br />Contact Name: z. scott eeadricks <br />Address: Centennial Materials Inc. <br />2635 Delta Drive / <br />Colorado Springs, CO 80910 <br />Phone: ( 719 ) 392-9207 <br />~t~\ ~a~ <br />l~ <br />"r <br />