2001-02-26_REPORT - M1988093

• Permit No: M1988093
• IBM Index Class Name: Report
• Doc Date: 2/26/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME: Fremont Paving& Redi-Mix, Inc. RECEIVED
FEB
PERMIT NO.: M-1988-093 2 6 2001
OPERATION NAME: Fremont Paving& Redi-Mix Pit Divislon of Ninerals and Geology
ANNIVERSARY DATE: March 3,2001
ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date)
COUNTY: Fremont
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 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 year, new disturbances that are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the yearjf any.
4' Please attach your revised written annual report and annual report map to'this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written
report.
Division records indicate the following pennittee contact information. Please verify and make any necessary
changes:
Permittee Contact Angela Bellantoni
Permittee Name: Fremont Paving& Redi-Mix, Inc.
Address: P.O. Box 841 PO 13ox 17 2U
Canon City, CO 81215-0841
Phone Number: [phone]
Fax Number: [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 instructions are
enclosed.
Signature oorate Officer or Owner
Date
m�rEP-M]T\ ASTERDOCUMErrrsv.1-AF-01