2008-03-17_REPORT - M1987028

• Permit No: M1987028
• IBM Index Class Name: REPORT
• Doc Date: 3/17/2008
• Doc Name: Annual Fee/Report/Map
• From: Colorado Marble, Inc
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

02/08/2008 15:15 FAX [phone] PAVESTONE#40 1~J003/003
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P)~RMIT"TEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNT~ERSARY DATE;
ANNUAL >='EE DUE:
COUNTY:
~~ ~ RBT
ANNUAL FEE and ItEPOR RE VEST
Colorado Marble, Ina
M-1987-028
Llly Mines
March 18, 2008
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MAR 17 2008 /
Division ofa d Safety n
Mm-n9
$5791.00 (Due oa or before your annlvors~~y dlate)
ChatPee
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 di,s~hubances to affected land,
reclarnatiotr accomplished to date and during the-preceding year, new disturbances tlitat~are-anticipated to occur -
,_ during the upcoming year, reclamation that will be performed during the coming y ear., the dates for the beginnins
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report man to tlais Corm. T>te Annual Report
& Fee requirement is not met until we have received the following componen~s~ifee. report. and associated
man. If no new disturbances or reclamation have occarred during the nrevlouis year and no new chances to
the previous year's maQ are necessary. then no new map is required, provided t~.rt the Operator shall state
this In the Annual lteoort. Please note that an adequately labeled map that cleclrly delineates and includes the
above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Bill ,4ddison
Permittee Nanrae: Colorado Marble, Inc.
Address: 229 Industrial Park Rd NE
Cartersville, GA 30121
Phone Number: (770) 6073345
Fax Number: [phone] ,_
Tf you have additional comments and/or information that should be provided to the Division, please provide it
below or att it to thi orm along with your written report sad map. Annual Report instructions arc enclosed.
Signature of Corporate Officer, Owner, or Designee
Date