2005-11-07_REPORT - M1987116

• Permit No: M1987116
• IBM Index Class Name: Report
• Doc Date: 11/7/2005
• Doc Name: Annual Fee/Report/Map
• From: Colorado Quarries Inc
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
A,~NrN'TiAT. FF.F. and RF.P(lRT RF.nTTFST
7
~olorado Quarries, Inc.
M-1987-116
Siskin
November 2, 2005
~~~ v
RECEIVE
/NOV 01 2005
t11Y1Slan of Minerals and Geology
$281.00 (Due on or before your anniversary date)
Custer
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
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written anmral rernrt and anneal rennrt m ~n to this form- Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Bill Tezak
Permittee Name: Colorado Quarries, Inc.
Address: 270 S. 15th St.
Canon City, CO 81212
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
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Signature Corporate Officer, Owner, or Designee
/~ ~ - d S
Date. ~ ~ ~ ~ ~y;~ ~ ~C7 (/ ' ~ e
No ~~~~~~