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iYi~az <br />/o -i3 -c~ <br />~~- <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />i/ ANNUAL FEE and REPORT REQUEST <br />~ Luis M. Vasquez <br />M-1999-063 <br />Red Wolf Quarry <br />August 23, 2006 <br />F~,FG;~'9w A~~ <br />1/ Division of Reclamation, <br />Mining and Safety <br />$281.00 (Due on or before your anniversary date) <br />Lorimer <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 acfive 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 />moo (All are required regardless of the -evel of disturbance or absence of disturbance during the previous <br />year). Please note that an adequately labeled map that clearly delineates and includes the above elements may <br />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: Abe Vasquez <br />Permittee Name: Luis M. Vasquez <br />Address: P.O. Box 122 <br />Phone Number: <br />Fax Number: <br />Lyons, CO 80540 <br />(303}823-6116 <br />(303)823-6888 <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 afore orporate Officer, Owner, or Designee <br />-lU-d~ <br />Date <br />