2017-07-05_REPORT - M1999005

• Permit No: M1999005
• IBM Index Class Name: REPORT
• Doc Date: 7/5/2017
• Doc Name: Annual Fee/Report/Map
• From: All-Rite Paving & Redi-Mix
• To: DRMS
• Annual Report Year: 2016
• Email Name: AME
• Media Type: D
• Archive: No

Page 5 of 5
Division records indicate the following permittee/landowner contact information(blank fields indicate that we do not have
information on record). If this information is blank or not current,please type or print current contact information:
Permittee Contact: John P. Ary
Permittee Company: All-Rite Paving&Redi-Mix,
Inc.
Address: P.O. Box 165
Canon City, CO 81215
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact: Jodi Schreiber
Company: All-Rite Paving&Redi-Mix,
Inc.
Address: P.O. Box 165
Canon City, CO 81215
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
Inspection Contact: Jodi Schreiber
Company: All-Rite Paving&Redi-Mix,
Inc.
Address: P.O. Box 165
Canon City, CO 81215
Phone Number: [phone]
Fax Number: [phone]
Email Address: [e-mail]
1,the undersigned,hereby state that the info on provided in this report is true and accurate, and that site operations are
bein d cted in cordance with ivision approved mining and reclamation plans.
11) wjo
Signa re o ermitte or ,fTicer,Owner,or Documented Designee Date
M-AF-01