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t/ <br />ANN1iA1, FF,F, and RF,PnRT RFnfiF.RT <br />PERMITTEE NAME: Robins Construction Co. LLLP ~ECC~ VE~ <br />PERMIT NO.: M-2002-014 -MAY Q 9 X03 <br />OPERATION NAME: Robins Pit No. 1 pirisiaa ai Minerals and Geelogy <br />ANNIVERSARY DATE: May 16, 2003 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Conejos <br />According to C.R.S. 34-32,5-1 I6 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee; areport-and map-showing the exteYU of°curren[ distwbanoes,to affected tand; <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 ym~r revised written annual rennrt and annual report main to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Randy Robins <br />Permittee Name: Robins Construction Co. LLLP <br />Address: P.O. Box 2I2 <br />Antonito, CO 81120 <br />Phone Number: (719) 376-2351 <br />Fax Number: (7] 9) 376-2651 <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with yow written report and map. Annual Report instructions are enclosed. <br />Signatwe~e Office-6 / r, Owner, Or Designee <br />Date <br />t°~ vL ~/` <br />Kti~. ~t> y+sG <br />N~/ Pt l..s'r td„ <br />GVk,J` ~k <br />ll 4~5 <br />VW <br />M:~PERMITMASTERDOCUMENTSVvf-AF-01 <br />