2006-09-28_REPORT - M1987049 - Laserfiche WebLink

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p ~,n~ ANNUAL FEE and REPORT REQUEST PERMTITEE NAME: Ready Mixed Concrete Company ~ PERMIT NO.: / / M-1987-049 OPERATION NAME: Bromley Lakes ANNIVERSARY DATE: September 29, 2006 ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) COUNTY: Adams 1'11`!~- ~ o `l ° -p6 '/ SEP 2 82006 / Dlvlsion otReclamatioq ~'nin8 and Safety 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 shall submit the annual- fee, a- report -and-map- showing the ex±ent of current disturbances to affected land, 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 vour revised written annual report and annual report map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated map (All are required regardless of the level of disturbance or absence of disturbance during the previous year). Please note that an adequately Zabeled map that clearly delineates and includes the above elements may suffice for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: I'itfitildns~~l~'i Permittee Name: Ready Mixed Concrete Company Address: CF.PR.address 1 14585 Old Brighton Rd. Brighton, CO 80641 Phone Number: (303) 659-0630 Fax Number: If you have additional comments andlor 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 instructions are enclosed. Signature o~ ~ Corporate Officer, Owner, or Designee ~= ~aG Date