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'v <br />f - '7 <br />A?:: -J, RAT <br />PERMITTEE NAME: ' <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT RUOUEST <br />Colorado Lime Company <br />M-2000-098 .// <br />Monarch Quarry <br />January 15, 2010 <br />$791.00 (Due on or before your anniversary date) <br />Chaffee <br />Fr <br />'IVE® <br />V..,/ ,IAN 19 2010 <br />? Divi6ion of Reclamation, <br />Mining and Safety <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 your revised written annual report and annual report may to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new chances to <br />the previous year's may 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 suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: <br />Permittee Name: <br />Address <br />Phone Number: <br />Fax Number: <br />Tracy Gunn <br />Colorado Lime Company <br />1468 Hwy 50 <br />Delta, CO 81416-3119 <br />(970) 874-8300 <br />(970) 874-8366 <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*"/ - ai <br />Signature of Corporate Officer, Owner, or Designee <br />/ -12 <br />Date