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<br />RECEIVED <br />PERMTTTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Castle Concrete Company <br />M-1977-376 <br />Canyon Dolomite Quarry <br />September 22, 2002 <br />AUG 2 0 2~2 <br />Dirisioa of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Fremont <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 14 affectcd_IaLtd ~_ . <br />reclamation accomplished to date and during [he 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 resort mau 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 [he following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: B. J. Fuller <br />Permittee Name: Castle Concrete Company <br />Address: ~ <br />`I`~`1 ~ 1 ~~5~~~~5lie~ <br />Colorado Springs, CO 8~9@'~ ~~~~ <br />Phone Numbec (719) 475-0700 <br />FaxNu-tnber:_ _ - \ ~ ~ -~ - <br />-,- <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 />~- <br />Signature of C orate Officer, Owner, or Designee <br />Date <br />M:~PERM n1MASTERD000MENT5NI-AF-01 <br />