REP01532

• Permit No: M1974086
• IBM Index Class Name: Report
• Doc Date: 7/17/2002
• Doc Name: 2002 Annual Report
• From: Asphalt Paving Company
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITfEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Asphalt Paving Company
M-1974-086
Ralston Quarry
July 24, 2002
RECEIlfE®
JUL 1 ? 2002
Division of Minerals and Geology
$688.00 (Due on or before your anniversary date)
Jefferson
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
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased For the year, if any.
Please attach your revised written annual report and annual report map to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elemznts may since for a written report.
Division records indicate [he following permittee contact information Please verify and make any necessary
changes:
Permittee Contact:
Permittee Name: Asphalt Paving Company
Address: 14802 W. 44th Ave.
Golden, CO 80403
Phone Number: (303) 279-66] 1 ~c 2 3~
Fax Number: [phone]
G. u[.G~i C F/tyitu aF('
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If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instmctions are enclosed.
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