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oA <br /> A' 9F-1- <br /> ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: Acontinental Materials Corporation <br />PERMIT NO.: t4-1977-376 <br />OPERATION NAME: Canyon Dolomite Quarry <br />ANNIVERSARY DATE: September 22, 2008 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <br /> <br /> <br />?OCT " 0 X00 <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 eeased 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 map. <br />If no new disturbances or reclamation have occurred during the previous year and no new changes to the <br />previous year's map are necessary, then no new map is required, provided that the Operator shall state this <br />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: es / Q r k !C U IV <br />Permittee Name: Continental Materials Corporation <br />Address: 444 E. Costilla <br />Colorado Springs, CO 80803 <br />Phone Number: (719) 227-2025 -r/ V 416 46 p1 <br />Fax Number: (719) 475-0226 <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 enclosed. <br />VP ... W <br />6P <br />Signatu e of Corporate Officer, Owner, or Designee <br />16- a00- 08 <br />Date