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iii iiiiiiiiniiiiii ~ <br />ANNUAL REPORT <br />• <br />:,=1~ED <br />PERMITTEE NAME: Dorn Ready-Mix Corp <br />PERMIT NO.: M-74-092 r^.~~ <br />OPERATION NAME: Barlow Pit ~'^~ & Geplpyy <br />ANNNERSARY DATE: October 31, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 ~j <br />COUNTY: Morgan <br />~~ <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during [he upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this <br />etulUal rCpOrt. P/rrrsr• nrrlr 7hru un udryrrrur/r hrhrlrrl mrrp that rlnrrlc dr/hn rur~ ~ur,l <br />includes dre above elements nary suffice jar « tirritren report. <br />Please type or print the current contact penun's name, mailing address, and phone number in the <br />space provided: <br />Contact Name:_2'/~lLy~~L~ 6G~L/H~~j Company:~Oi ~ <br />Address: CJ Phone No.: (faJ~J ) ~r~apr7- ~~lo~ <br />~~ Fax No.: (! JG ) CS~7~ ~y~ <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />Stgn re of Corporate O cer, or Owner Date <br />INSTRUCTIONS ON BACK <br />