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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Loveland Ready Mix Concrete, Inc. <br />M-1974-069 <br />Larimer Pit <br />July 31, 2003 <br />RECE~ VED <br />AUG 0 5 ?003 <br />Uirision •/Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Larimer <br />According to C.R.S. 34-32.5-116 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 map showing the extent of current disturbances to affected land, <br />--- -reclamation accomplished to date and during-the-precedingyear, new disturbances tharare anticipated to occur --- <br />during-the-upcoming-year,-reclamation-that-will-be-performed-during-ihe-coming-year,-the dates-fcr-the-beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written annual rennrt and annnal rennrt mad to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Steve A. Fancher <br />Permittee Name: Loveland Ready Mix Concrete, Inc. <br />Address: P.O. Box 299 <br />[~E'ORC~E ~TEVEN fANCyER <br />181 I W. 12th St. <br />Loveland, CO 80539 <br />Phone Number: (970) 667-2680 <br />Fax-Number: (970)'667=0036 <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 />Si of rate O tcer, Owner, or Designee <br />cfu.yc¢ .3U~ .ZdO 3 <br />Dale <br />goo - 4A--4(o04 <br />M:\PERM ITU~IASTERDOCUMENTSVN-AF-01 <br />