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/arc-- <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />hhp <br />V ANNi7Ai. FF.F, and RF,PORT RF.niiF.ST <br />j/ Valco Canon City Concrete Div <br />M-1977-559 <br />Canon City East Pit <br />February 22, 2006 <br />'~~~EIV~p <br />v~e 15 2006 <br />'/roision of Mme21s and G~~~, <br />$688.00 (Due on or before your anniversary date) <br />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 <br />- "-`operatorshall'submit the annual fee; a report and map showing the extern of current disturbances to affected <br />land, reclamation-accomplished-to-date and during the preceding-year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, iFany. <br />Please attach ymir revised written anneal rennrt and anneal re nrt 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 <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Randy Symons <br />Permittee Name: Valco Canon City Concrete Div. <br />Address: 730 S. Mackenzie <br />P.O. Box 669 <br />Canon City, CO 81215-0669 <br />Phone Number: (719) 275-7441 <br />Fax Number: (i 19) 275-747G <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 <br />en/clos~ed~). // <br />ifs(` .} n_ _ <br />Si e of Corporate Officer, Owner, or Designee <br />~1~. I~ ~OOG, <br />Date <br />M:NERMI7IMASTERD000MENTSIM-AF-04 <br />