2005-07-14_REPORT - M1992058

• Permit No: M1992058
• IBM Index Class Name: Report
• Doc Date: 7/14/2005
• Doc Name: Annual Fee/Report/Map
• From: colorado quarries inc
• To: dmg
• Media Type: D
• Archive: No

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ANN1iAi. FF.F, and REPORT RF.QiTF.ST ~UL 1 4
PERMITTEE NAME: Colorado Quarries, Inc. 61~t&tefl®t Mln@ret$
end Geology
PERMIT NO.: M-1992-058
OPERATION NAME: Mica White
ANNNERSARY DATE: August 5, 2005
ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date)
COUNTY: Fremont
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
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming yeaz, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written anneal re~nrt and anm~al rennrt mgp to this fnrm~ Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice jor a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Bill Tezak
Permittee Name: Colorado Quarries, Inc.
Address: 270 S. 15th St.
Canon Ciry, CO 81212
Phone Number: [phone]
Fax Number: [phone]
1f you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instnactions are enclosed.
Si afore of 'orporate Offi er, t r esignee ~ ~ ~ ~ ~ 1, ~i
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Date