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r~ <br />J <br />~~:~~rcd'll~fC~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Asphalt Constructors, Inc. <br />M-2001-069 <br />Del Norte West Valley Pit <br />November 5, 2003 <br />OCT 111003 <br />division of PAiner~ls ;nd Genlr~- <br />$688.00 (Due on or before your anniversary date) <br />ltio Grande <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 />shall submit-the annual-fee, a report and map. showing the extent of current disturbances 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 Xpur reviced written annnal report and annual report m ~n to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may sufftce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Todd Stockebrand <br />Permittee Name: Asphalt Constructors, Inc. <br />Address: 7040 W. Hwy. 160 <br />Alamosa, CO 81101 <br />Phone Number: (719) 589-6671 <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 Report instructions are enclosed. <br />GlL~.Y/ ~/ ~j G`f/ ~GCJ~o ~ ~1.¢.~ <br />Signature of Co~ OfScer, Owner, or Designee <br />~~ - l 7 -~ <br />Date <br />M:~PERMIN7ASTERD000MENTSVN-AF-01 <br /> <br />