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<br />RECEIVED <br />APR 1 5 2003 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Fremont Paving &Redi Mix, Inc. <br />M-2000-151 <br />McCumber Hill Pit <br />April 18, 2003 <br />$688.00 (Due on or before your anniversary date) <br />Fremont <br />Division ~f Minerals and Geology <br />According to C.R.S. 34-32.5-I 16 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 Snap, showing the_extent .o£ current,disturbances-1o_ 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 />Pl as atta h ynnr revised written annual rennrt and anneal rennrt maT to this form. Please note [hat an <br />adequately labeled map that clearly delineates and includes the 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: TnglMartitt <br />Permittee Name: Fremont Paving &Redi Mix, Inc. <br />Address: P.O. Box 841 <br />Canon City, CO 81215-0841 <br />Phone Number: (719) 275-3264 <br />Fax Number: (719) 275-8897 <br />~ 1 Au to iCP (~'~/1 ~~.~' <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 />S' afore of Corporate O Icer, Owner, or Designee <br />`f~ll ~O <br />Date <br />M:~PERMnU1ASTERD000M ENTSUA-AF-01 <br />