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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Southway Construction Company, Inc. <br />M-1987-013 <br />Burton Pit <br />May 6, 2002 <br />$281.00 (Due on or before your anniversary date) <br />Rio Grande <br />FiECE-~E® <br />MAY d 6 2002 <br />Division of Minerals and Geology <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 operator <br />_~~shalLsubmit_the_annual_fee,_a_report_and.map_showing the_extent~of_current_distucbances_to_affected-land, -. <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated 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 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 includes the 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: Kris DeGolyer <br />Permittee Name: Southway Construction Company, Inc. <br />Address: 117 White Pine Dr. <br /> Alamosa, CO 81101 <br />Phone Number: (719) 589-5103 <br />_ ~ _ <br />_ <br />- <br />- -~ <br />Fax Number: (719) 589-5522 - ~- <br />-- - <br />-_ _ - ~ - <br />_ <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 Repor[ instructions are enclosed. <br />Signature of Corporate Officer or Ow er <br />OS-03-02 <br />Date <br />M:NERMI7IMASTERD000MENTSNt-AF-01 <br />