2017-08-30_M1980224_Annual Fee Notice ARCHIVE

• Permit No: M1980224A
• IBM Index Class Name: Report
• Doc Date: 8/30/2017
• Doc Name: Annual Fee Notice
• From: DRMS
• To: Fremont Paving & Redi-Mix, Inc.
• Annual Report Year: 2017
• Media Type: D
• Archive: Yes

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:

Fremont Paving & Redi-Mix,
Inc.

Address:

P.O. Box 841
Canon City, CO 81215

Phone Number:

[phone]
Fax Number: [phone]
Email Address: [e-mail]
Permitting Contact:

Jodi Schreiber
Company:

Environmental Alternatives, Inc.
Address:

1107 Main St.
Canon City, CO 81212

Phone Number:

[phone]
Fax Number: [phone]
Email Address: [e-mail]
Inspection Contact:

Jodi Schreiber
Company:

Environmental Alternatives, Inc.
Address:

1107 Main St.
Canon City, CO 81212

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
being conducted in accordance with the Division approved mining and reclamation plans.

Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date
M-AF-01