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REP17042
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REP17042
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Entry Properties
Last modified
8/24/2016 11:46:10 PM
Creation date
11/27/2007 2:01:53 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1977053
IBM Index Class Name
Report
Doc Date
11/24/2003
Doc Name
2003 Annual Fee and Report
From
Asphalt Constructors Inc.
To
DMG
Permit Index Doc Type
Annual Fee / Report
Media Type
D
Archive
No
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1 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Asphalt Constructors, Inc. <br />M-1977-053 <br />Lyle Smith Pit <br />December 23, 2003 <br />$688.00 (Due on or before your anniversary date) <br />Costilla <br />~~~~~~~~ <br />NOV 2 4 ~ <br />Division of Minerals and GeolollY <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 x,Dalr revised written annual refit and annual repprt man 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: Todd A. Stockebrand <br />Permittee Name: Asphalt Constructors, Inc. <br />Address: P.O. Box 449 <br />Alamosa, CO 81101 <br />Phone Number: (719) 589-6671 <br />Fax Number: (719) 589-0927 <br />7040 IIWY 160 W <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~turrporate OffiG~r, or Designee <br />tl-`z/-03 <br />Date <br />M:~PERM ITMASTERDOCUMENTSVv7-AF-0I <br />
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