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AN AL FEE'and REPORT REOUEST <br />Rn'j1 <br />PERMITTEE NAME: ?aThe Turquoise Connection, Inc. ? d <br />PERMIT NO.: ?M//-2007-031 Aim 1 LO o <br />OPERATION NAME: Scott Blue II ivision of Reciarna4lon? <br />ANNIVERSARY DATE: July 5, 2010 T11)' 19?n?^ saf ety+ <br />ANNUAL FEE DUE: $$259.00 (Due on or before your anniversary date) <br />COUNTY: Teller <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 <br />___ sQperator. shalLsubmit-the-annua]_fee,-a-rep-ort andmaRshowing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning 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 <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map If no new disturbances or reclamation have occurred during the previous year and no <br />new chanizes to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the 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: Foster G. Scott <br />Permittee Name: The Turquoise Connection, Inc. <br />Address: 910 Phay Ave <br />Canon City, CO 81212 <br />Phone Number: (;4.9-?-G?S-' <br />Fax Number: <br />7d9 -994- $ 553 <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 <br />enclosed. <br />r <br />Signature of Corporat Officer, Owner, or Designee <br />?? - 2-0161 <br />Date <br />M:IPERMII\MASTERDOCUMENTS/M-AF-02. DOC