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K i <br />A <br />ANNUAL F9E an(IREPORT REQUEST <br />PERMITTEE NAME: 4 d Canyon, LLC <br />7 <br />PERMIT NO.: "M-1985-043 APR 2 I 2011 <br />OPERATION NAME: Red Canyon Quarry I)iVisirrt ?I Ne rabon, <br />Mining and Safety <br />ANNIVERSARY DATE: May 6, 2011 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <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,- pew 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 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 />map. If no new disturbances or reclamation have occurred during the previous year and no new changes 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 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: Bob Stack <br />Permittee Name: Red Canyon, LLC <br />Address: 3131 Barrett Rd. <br />Colorado Springs, CO 80926 <br />Phone Number: (719) 576-0563 D 42 3 L O g(? <br />Fax Number: (719) 576-0563 72 1 % '-1,z' d5 <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 forrp)atong with your written report and map. Annual Report instructions are enclosed. <br />of <br />, Owner, or Designee <br />Date <br />101 <br />16