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l ~J <br />PERMI"ITEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />ARS Sand & Gravel Co., LLC <br />M-1980-020 <br />Braley S&G Pit No 1 <br />July 15, 2002 <br />RECEIVED <br />JUL 0 9 2002 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Douglas <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall submit the annual -fee, a report an'Ir map showing the extent of curretit dis[u~bances to affected-lan8;-' <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during [he upcoming year, reclamation that will be performed during [he coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following perrnittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: -3ehmGenatrr (~. ~J~ ~l~C/_~$~'~l_ <br />Permittee Name: ARS Sand & Gravel Co., LLC <br />Address: 8505 W. Mtn. View Ln. <br />Littleton, CO 80125-000 <br />Phone Number: (303) 791-7404 ~3 03) 3 y6 - ~y,`/~~"o <br />Fax Number: (303) 791 30~ "~~ ~ ' ~ T~~ <br />L` 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 instmctions are enclosed. <br />s; ~. 6~- <br />Signature of Corporate Officer or Owner <br />Date ~ <br />M iPERMIT\MASTERDOCUMENTSN~I-AF-01 <br />