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~~f~/ ' <br />ANNUAL FEE and REPORT REQUEST <br />~ R~C~~A1~~~ <br />PERMITTEE NAME: Southway Construction Company, Inc. <br />PERMITNO.: t~I-1988-087 ~~~ 1 Q~~QA~ <br />OPERATION NAME: Swede Corners Pit -~~s!'m ot~~ <br />lNigi.~q <br />ANNNERSARY DATE: January 13, 2007 <br />ANNUAL FEE DUE: $$281.00 (Due on or before your anniversary date) <br />COUNTY: 5aguache <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, 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 to affected land, <br />--- reclamation accompiishe2i-to date~ddirring the preceding mar,-new disturbances thaf are anticip-armed 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 yeaz, if any. <br />Please attach vour revised written annual report and annual resort maa to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous vear and no new changes to <br />the previous year's map are necessary, then no new map is required, provided that the Oaerator shall state <br />this in the Annual Resort. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Ralph Martinez <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 />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />--~ ~~ <br />Signa a of Corporate O ~cer, Owner, or Designee <br />Date <br />