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rCD <br />ANNiiAi, FF.F, and RF,PtiRT RF.niTFST <br />PERMITTEE NAME ' <br />S <br />th <br />C <br />i <br />C REC+E'~~ <br />: ~ <br />ou <br />way <br />onstruct <br />on <br />ompany, Inc. <br />PERMIT NO.: / <br />t~ M-1987-013 ,,SAY p g 2p06 <br />OPERATION NAME: Burton Pit <br />rals end aeolugb' <br />, <br /> " Ilntsion of Mine <br />ANNIVERSARY DATE: May 6, 2006 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Rio Grande <br />n~~~-- <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 pennit, 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.eceur -- <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 anneal re~nrt and anm~al re n~rt _mgn 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: Ralph Martinez <br />Permittee Name: Southway Construction Company, 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 />Signa~~f Corpor Officer, Owner, or Designee <br />~~y~ <br />Date <br />_r <br />