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bmk <br />~ ~ ~ p l~ <br />AL FEES and REPORT RE VEST <br />PERMITTEE N YCity of Colorado Springs <br />PERMIT NO.: ,~A+I-1989-116 <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Crystal Pit <br />March 26, 2008 <br />~ci~:~ <br />BAR 2 6 2008 <br />Div}~ian os Keciamation, <br />/Mining and Satety <br />$$323.00 (Due on or before your anniversary date) <br />Teller <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 <br />--=operater-shall-~.~~'~-n,-a*~nual-fee,-a-repert-.and-m?p--shew?ng hg-event-of-curr-ent.di-sturbances-to_affest~.d-------__ <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous vear and no <br />new changes to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />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: Dave D. Jordan <br />Permittee Name: City of Colorado Springs <br />Address: P.O. Box 1575 <br /> Mail Code 060 <br /> Colorado Springs, CO 80901-1575 <br />Phone Number: (719) 385-7715 <br />Fax Number: (719) 684-2234 <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 <br />enclosed. <br />ign t~r~e~of Corporate Officer, Owner, or Designee <br />~ ! lT~~ <br />Date <br />M:~PERMITIMASTERDOCUMENTS~M-AF-04 <br />