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ANNUAL ~EE and REPORT REpUEST <br />PERMITTEE NAME: ~ Southway Construction Company, Inc. c <br />PERMTI' NO.: ~M-1995-060 ~C ~~r ~`~® <br />OPERATION NAME: Butcher Pit rMAR ;j Q 200j <br />ANNIVERSARY DATE: April 1, 2007 ~w"'on of a,„,- <br />ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary da't )anU Sa ety q <br />COUNTY: Alamosa <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 />_ __reclamar;n_, n a~comnli~r~d_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 resort moo to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous vear and no new chanties to <br />the arevious year's moo are necessary. then no new moo is required, provided that the Operator shall state <br />this in the Annual Reuort. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Ralph Martinez <br />Permittee Name: Southway Construction Company, Inc. <br />Address: 117 White Pine Dr. <br />Alamosa, CO 81101 <br />Phone Number: (719) 589-5103 <br />Fax Number: (719) 589-5522 <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 />A <br />Signature Corporate Offic per, or Designee <br />3~zS~o7 <br />Date <br />