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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Southway Construction Company, Inc. <br />M-1995-060 <br />Butcher Pit <br />April 1, 2004 <br />Aar1 U 1 cuu~r <br /> <br />Division of Minerals & Geology <br />$688.00 (Due on or before your anniversary date) <br />Alamosa <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-io 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 ymrr revised written annual re}inrt and anmral report m ~n to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: 1. <br />Permittee Name: Southway Construction Company, Inc. <br />Address: 117 White Pine Dr. <br />Alamosa, CO 81101 <br />Phone Number: (719) 589-5103 <br />Fax Number: (719) 589-5522 <br />l~a~jr ~q,r%~»ez <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 />Sig~~Corpo~er, Owner, or Designee REC <br />EE~/ED <br />.~- 30 - a y APR 012004 <br />Date <br />Division of Mioerz~ ~ Geelagy <br />