2006-08-14_REPORT - M1984101 - Laserfiche WebLink

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I ~~r ANNUAL FEE and REPORT REQUEST PERMITTEE NAME: `~ Hard Rock Paving &Redi-Mix, Inc PERMIT NO.: ~M-1984-101 RECEIVED ~~auc i a Zoos //uivision of ReGamation, Mining and Safety OPERATION NAME: Chaparral Meadows Pit ANNNERSARY DATE: August 13, 2006 ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) COUNTY: Park 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 fee, a report and map showing the extent'of current disturbances to affected land, reclamation accomplished-fo date and during the preceding year,-new distwliai3ces that are anti`cipated-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 your revised written annual reuort and annual report map 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: John Paul Ary Permittee Name: Hazd Rock Paving &Redi-Mix, Inc. Address: P.O. Box 1720 Canon City, CO 81215-1720 Phone Number: (719) 275-1280 Fax Number: (719) 275-8897 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 ong with your written report and map. Annual Report instructions are enclosed. ature ofQCorporate Officer, Owner, or Designee O -~~ Dln Date