REP10596

• Permit No: M1992016
• IBM Index Class Name: Report
• Doc Date: 8/1/2006
• Doc Name: Inadequate ltr
• From: DMG msr
• To: Rocky Mountain Materials & Asphalt Inc.
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PEILMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Rocky Mountain Materials & Asphalt, Inc.
M-1992-016
Penrose Ranch's
June 24, 2006
$688.00 (Due on or before your anniversary date) ~
Fremont
i
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an
operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected
land, reclamation accomplished to date and during the preceding yeaz, new disturbances that aze anticipated to
occur during the upcoming year, reclamation that will be performed during the coming yeaz, the dates for the
beginning of active operations, and the date active operations ceased for the yeaz, if any.
• revised written annual report and annual report map to this form. Please note that an
map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Rob Mangone
Permittee Name: Rocky Mountain Materials & Asphalt, Inc.
Address: 1910 Rand Ave.
Colorado Springs, CO 80906
Phone Number: [phone]
Fax Nttmber: [phone]
If you have additional comments and/or 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 ittstructions aze enclosed.
Signature of Corporate Officer or Owner
Date