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f~F~hP% <br />r~~ <br />PERMITTEE NAME: <br />PERMIT NO.: M 1978 271 RECEI ~/~ <br />OPERATION NAME: Garrett Pit <br />ANNNERSARY DATE: October 30, 2005 ~OCT 2 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversa~0~a~~9 of Minerals s„d ;,~„ <br />COUNTY: Conejos <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 />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 />Please attach ynnr revised written annnal rernrt and annnal rennrt map to this form- Please note that 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: Rock I. Southway <br />Permittee Name: Asphalt Gravel Products, 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 />Signature Of C-~ fficer, Owner, or Designee <br />A~-~N/N`TiAi. FF,F, and RF.PnRT A <br />~ A phalt Gravel Products, Inc <br /> <br />/O~ ~d <br />Date <br />