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ANNUand P EQ EST <br />O <br />PERMITTEE NAME: AC lorado City Metropolitan District <br />PERMIT NO: M-1979-158 <br />OPERATION NAME: Mountain Shadows Pit <br />ANNIVERSARY DATE: December 20, 2008 <br />b1nk <br />RECEIVED <br />p&4 15 2009 <br />Division of Reclamation, <br />43 Mining and Safety <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Pueblo <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 of <br />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 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 above <br />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: David Valdez <br />Permittee Name: Colorado City Metro District <br />Address: 4497 Bent Brothers Blvd <br />PO Box 19390 <br />Colorado City CO 81019 <br />Phone Number (719) 676-3396 <br />Fax Number (719) 676-3172 <br />If you have additional comments and/or information that should be provided to the Division, <br />please provide it below or attach it to this form along with your written report and map. Annual <br />port inst tions re cl ed. <br />C <br />n <br />of Corporate Of er, Owner or Designee