2001-09-12_REPORT - M2000052

• Permit No: M2000052
• IBM Index Class Name: Report
• Doc Date: 9/12/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

• III IIIIIIIIIIIII III •
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ANNUAL FEE and REPORT REOUEST
PERMITTEE NAME: Rocky Mountain Materials & Asphalt,Inc. RECEWEE)
PERMIT NO.: M-2000-052
OPERATION NAME: Coyote Ridge SEP 12 2001
ANNIVERSARY DATE: September 11,2001 Division of Minerals and Geology
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, n'ew disturbances that are anticipated f6 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 year, if any.
Please attach your revised written annual report and annual report map to this form. Please note that an
adequate1v labeled rnap that clearly delineates and includes the above elements miry suffice fora written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: GwRQeAZRS`.ir: T�,m Sr» t fi 1
Permittee Name: Rocky Mountain Materials & Asphalt, Inc.
Address: 1910 Rand Ave.
Colorado Springs,CO 80906
Phone Number: [phone]
Fax Number: (7I9) 473-3109
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.
Signa\U,
e of C rporate Offi or Owner
0
Date
M iPERMri"NIASTERDOCUMENTS\NI-AF-01