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~: <br /> <br />(~ i1/) <br />v ANNiiAt, FF,F, and RFPnRT RF.lli1F,ST <br />RECEIlfED <br />fEE NAME: / Hsrd Rock Paving &Redi-Mix, Inc. <br />No.: ,~ M-1977-195 / APR 2 1 2006 <br />ION NAME: Hard Rock 291 Pit v Division d Miaerols and Geology <br />RSARY DATE: Apri121, 2006 <br />FEE DUE: $281.00 (Due on or before your anniversary date) <br />': Chaffee <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I 16, 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 accomplisfi'ed`to date-and-during the p--~iec3ing year, new distiuban'^ces ftia't ai•e anticipated to occuc~ <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 />ich ynnr revised written annnal report and anm~al report mar this form. please note that an <br />labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />isioti records indicate the following permittee contact information. Please verify and make any necessary <br />Contact: Denise Gonzales <br />Name: Hard Rock Paving &Redi-Mix, Inc. <br />P.O. Box 1720 <br />Canon City, CO 81215-1720 <br />Phone Number: (719) 275-1280 _ _ <br />Fax Nu I ber: (719) 275-8898 <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 />~tgn~ttre of ~:orporate vutcer, owner, or ttestgnee <br />Date ~ <br />