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db/- o/< <br />ANAL FEE and RE CQRT REQUEST <br />PERMITTEE NAME: `?C chmidt Construction Company <br />???CCC -1989-065 <br />PERMIT NO.: / <br />OPERATION NAME: Winkler Light Aggregate Quarry <br />ANNIVERSARY DATE: April 26, 2010 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Douglas <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 pormec r , - b n <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour 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 year'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: Scott Davis <br />Permittee Name: Schmidt Construction Company <br />Address: 2635 Delta Dr. <br />Colorado Springs, CO 80910 <br />Phone Number: (719) 392-4207 <br />Fax Number: (719) 392-4245 <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 />A '4 zf&/?'o <br />Signature of Corporate O frcer, Owner, or Designee <br />Date APR 2 f 2010 <br />pWWw of Rec?a"Wn.