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• III IIIIIIIIIIIIIIII <br />' ~',r ANNUAL REPORT <br />PERMITTEE NAME: ARS Sand R Gravel Co., LLC gE~NEr <br />PERMIT NO.: M-1980-020 ,IUL '12 ~~~ <br />OPERATION NAME: Braley S&G Pit No 1 i~erals & ~~eolOgll <br />ANNNERSARY DATE: July 15, 2000 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Douglas <br />RECEIVED <br />dUt: 1210 <br />ahsionolMirterrls iGeology <br />According to C.R.S. 34-32-116(3)(a), each yeaz, on the anniversary date of [he permit, an operator shall <br />submit the annual fee, a lepori and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during [he preceding year, new disturbances that are anticipated <br />to occur during the upcoming year, reclamation that will be performed during the coming year, [he <br />dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note that nn adequately labeled map tlwt clearly delineates unrl includes the above elements may <br />suffice for a lvrilten report. <br />Please type or print the current contact person's name, mailing address, a1d phone number in the space <br />provided: <br />Contact N~a7me: I - <br />Address: b S nS ~~7 ~U ~l ~t~i t Il UIfeJ <br />,t <br />Company: ~~~ ~r1t7 3 ~~rL~UC/1` <br />FAXNo.:(30~ )9~~ - 405 <br />e-mail: <br />If there are additional comments and/or information that should be provided to [he Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />Signature of Corporate Officer, ner <br />7- IU- 00 <br />Date <br />INSTRUCTIONS ON BACK <br />p,+ <br />M ~PERMrM1A5TERD000MENTSUI-AF-01 <br />