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<br /> ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Colorado Quarries Inc J* <br />PERMIT NO.: M-1977-168 <br />OPERATION NAME: Marrs Memorials <br />ANNIVERSARY DATE: November 30, 2008 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <br /> <br />OPT <br />2003 <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 showing the extent of current disturbances to 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 your revised written annual report and annual report map to this form The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous vear's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Bill Tezak <br />Permittee Name: Colorado Quarries Inc <br />Address: 270 S 15th St <br />Canon City, CO 81212 <br />Phone Number: (719) 275-6894 <br />Fax Number: (719) 275-2131 <br />If you have additional <br />below or attach it to this <br />Date <br />ents and/or information that should be provided to the Division, please provide it <br />along with your written report and map. Annual Report instructions are enclosed. <br />Designee <br />p 0 0, L 6-- ?-v