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~ ->> . <br />. // <br />Y <br />RECEi\1ED <br />PERMffTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />RBK Construction, Inc. <br />M-1990-106 <br />RBK Pit No. 30 <br />October 16, 2003 <br />ocr o s ~o~ <br />Division otMinerals and GeoloAY <br />$281.00 (Due on or before your anniversary date) <br />Pueblo <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 to affected land, <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 />~pase attach ynnr revised written annual rennrt and annual report man 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 pertnittee contact information. Please verify and make any necessary <br />changes: <br />Petmittee Contact: Ronda Neumeister <br />Permittee Name: RBK Construction, Inc. <br />Address: P.O. Box 376 <br />Phone Number: <br />Fax Number: <br />Rye, CO 81069 <br />(719)489-3385 <br />(719)489-2268 <br />If you have addifi~nal~omments and/or information that should be provided to the Division, please provide it <br />below~r attach i~to this form along with your written report and map. Annual Report instructions are enclosed. <br />Si(grtature of C6or/porate Officer, Owner, or Designee <br />~~ ~~/ 6~ <br />Date ~T <br />M:`PERM ITV.IASTERDOC UMENTSVvI-AE-01 <br />