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<br />PERMITTEE NAME <br />PERMIT NO.: <br />OPERATION NAME <br /> <br />ANNiiAI. FF,F. and RF.P(1RT RF.(liiF.ST <br />Colorado Quarries, Iuc. / <br />RECEIVED <br />NOV 13 2003 <br />II]Y157Dn O] Mi08fa76 afro ~,,. „~; <br />F~EG'~fsy~w® <br /> <br />M-1987-027 / NC,t 3 ;:::3 <br />1. . <br />Hardship L de Quarry Nysion of Minot;is and GeofoBY <br />ANNIVERSARY DATE: Nov ~mber 6, 2003 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Custer <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 />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 uy~r revised written anneal reo~rf and annual re~nrt m ~n to this form- Please note that an <br />adequately labeled map that clearly 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: Bill Te7ak <br />Permittee Name: Colorado Quarries, Inc. <br />Address: 270 S. 15th St. <br />Canon City, CO 81212 <br />Phone Number: (719) 275-6894 <br />Fax Number yy (719) 275-2 ] 31 <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 />Si nature of orporate Officer, Owner, or Designee <br />~~ ~~ ~ <br />Date <br />M:~PERMITMASTERD000MENTSUA-AF-01 <br />