2006-09-12_REPORT - M2000052 - Laserfiche WebLink

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~~ /ANNUAL FEE and REPORT REQUEST PERMITTEE NAME: ~ Rocky Mountain Materials & Asphalt, Inc. PERMIT NO.: ~M-2000-052 OPERATION NAME: Coyote Ridge ANNNERSARY DATE: September 11, 2006 ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) COUNTY: Fremont M~ RECEl~/ED ~ SEP 12 2006 ~ Division of Reclamation, Mining and Safety 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 -shall- submit the- annual-F e,- a report-and-map ~bowirg the extent of ccrr~..t distccbanczs to-af.`.;cted-land, - reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active operations, and the date active operations ceased for the year, if any. Please attach vour revised written annual report and annual resort man to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated map (All are required regardless of the level of disturbance or absence of disturbance during the previous year). Please note that an adequately labeled map that clearly delineates and includes the above elements may since for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Tom Smith Permittee Name: Rocky Mountain Materials & Asphalt, Inc. Address: 1910 Rand Ave. Colorado Springs, CO 80906 Phone Number: (719) 473-3100 Fax Number: (719) 473-3109 If you have additional comments and/or information that should be provided to the Division, please provide it below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. ~~~` Signature of Corporate Officer, Owner, or Designee /D- 7- d(o Date