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<br />ANNUAL FEE and REPORT REQUEST r3ECEIVED <br />PERMITTEE NAME: Akron Ready Mix DEC 1 6 2002 <br />PERMIT NO.: M-1997-015 Division of Minerals and Geology <br />OPERATION NAME: Elrick Pit <br />ANNNERSARY DATE: December 19, 2002 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Washington <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />---'rectanration-accomptrshed-to-date-and-during-the-preceding-pear,-new-disturbances-thst are-anticipated-te-occur---- <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and urcludes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Jill Darrell <br />Permittee Name: Akron Ready Mix <br />Address: 100 S. Cedar <br />P.O. Box J <br />Akron, CO 80720 <br />Phone Number: (970) 345-2003 <br />Fax Number: (!~-7&}34f24'i$ _ - 97d'3~s`-~d03 <br />If you have additional comments and/or information [hat 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 />~~~ <br />S'Qnature of Corporate Officer, Owner, or Designee <br />Date <br />h~G~,v~ ~us Cowtvuauc~6C <br />~;1~~ ~~ .~ -,~,~- ~~ iss-uPQ. <br />G~Ccor ~r `f'~ C iT1G,~t N~ <br />tvlCu1S C~ CLO~uw>~~s <br />MINER MI71MAS7ERD000MEN751M-AF-OI <br />