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iii iiiiiiiiiiiii iii ~ ®®1 <br />PERMITTEE NAME: Hard Rock Paving &Redi-Mix, Inc. R CEIVED <br />PERMIT NO.: M-84-101 <br />AU 0 3 1999 <br />OPERATION NAME: Chaparral Meadows Pit <br />,rvision Minerals g Geology <br />ANNNERSARY DATE: August 13,1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Park <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the pe t, an <br />operator shall submit the annual fee, a report and map showing the extent of curre t disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, ew <br />disturbances that are anticipated to occur during the upcoming year, reclamation t at will be <br />performed during the coming year, the dates for the beginning of active operation ,and the date <br />active operations ceased for [he year, if any. <br />annual report. Please mote that an adequately labeled map that c[eariy delinen~es and <br />includes the nbove elements mny suffice for n written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: John P. Ary COmpany:tiard Rock Pav n & Redi-Mix, Inc. <br />Address: Box 841 Phone No.: 71 275- 555 <br />Canon City, Colorado 81215-0841 Fax No.: 719 275- 897 <br />If there are additional comments and/or information that should be provided to they Division, <br />please provide it on a separate sheet and attach it to this report form along with yo r map and/or <br />written report. <br />G /~Q' <br />rgnature of Corporate Officer, or Owner <br />G~-a~- <br />Date <br />INSTRUCTIONS ON BACK <br />