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~'! l~- <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />/Colorado Quarries, Inc. <br />RCdr~~~~® <br />t/ M-1977-144 ~T 2 0 ?~1~}fl <br />Mica Lode Division of Reclamation, <br />Mining and Safety <br />November 30, 2006 <br />$688.00 (Due on or before your anniversary date) <br />Fremont <br />/~'1 ~77i <br />/d a ~ - l16 <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 />Please attach vour revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />man. If no new disturbances or reclamation have occurred during the previous vear and no new chances to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the following pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Bill Tezak <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: (714) 275-2131 <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 />r` <br />,e <br />Signature of Co orate Officer, Owner, or Designee <br />i~~ia-off <br />Date / <br />~~ ~~ ~-/r S y~i~ <br />~C S~< v~ y <br />