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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />AN AL FEt an REPORT RE UEST <br />ntinental Materials Corporation <br />M 1977-211 <br />Pikeview Quarry <br />May 27, 2010 <br /> <br />ECEIl n <br />AJUN 01 1010 <br />ion or rectarnatiort, <br />wing and Safety <br />$$791.00 (Due on or before your anniversary date) <br />El Paso <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 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: <br />) IDlee 411RO eI16 <br />Permittee Name: Continental Materials Corporation <br />Address: 444 E. Costilla <br />Colorado Springs, CO 80903 <br />Phone Number: 9) 22 2026 Q 0 <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 />Signature of X., ate Officer, Owner, or Designee <br />Date