2017-08-29_REPORT - M1987079

• Permit No: M1987079
• IBM Index Class Name: REPORT
• Doc Date: 8/29/2017
• Doc Name: Annual Fee/Report/Map
• From: All-Rite Paving & Redi-Mix, Inc.
• To: DRMS
• Annual Report Year: 2017
• 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]
I,the undersigned,hereby state that the information provided in this report is true and accurate, and that site operations are
beCOdu e • a rdance with the Division approved mining and reclamation plans.
11
Sign t of Permitte,Coryo,raticer,Owner,or Documented Designee Dat
M-AF-01 / i"