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• ui~ iiiiiiiiiiiu iii <br />999 <br />A.NNiJAL REPORT <br />PERMITTEE NAME: Centennial Materials, Inc. RECEIVED <br />PERMIT NO.: M-82-155 <br />DEC 3 p 1999 <br />OPERATION NAME: Fountain Pit <br />ANNIVERSARY DATE: December 31, 1999 Division of Minerab 8 Geology <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: EI Paso '•~ <br />According to C.R.S. 34-32.5-116(3)(a), 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 <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for the year, <br />if any. <br />Please attach your revised annual report map and written report to this annual repotK. Please <br />Hole that a~: adequately labeled »:ap that clearly delineates a~ui ir:cludes the above elements may <br />suffice for a writter: report. <br />Please type of print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: Scott Davis Company: Centennial Materials <br />Address:: 2635 Delta Drive Phone No.: (719 1392-4207 <br />Colorado Surines. CO 80910 Fax No.: (719 1392-4245 <br />Lf there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />,~~~jJJ~~~~ ~_ i <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />