2002-03-01_REPORT - M1977315

• Permit No: M1977315
• IBM Index Class Name: Report
• Doc Date: 3/1/2002
• Doc Name: Returned Annual Fee/Report Notice
• From: DMG
• To: Bestway Paving Company
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNP/ERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Beltway Paving Company
M-1977-315
Pit No. l
Apri] 23, 2002
$688.00 (Due on or. before your anniversary date)
Weld
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of [he permit, an operator
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
rec ama ton accomp is a to~c ate and during the preceding yeai, new disturbances that are anticipated to occur
during the upcotiting-year, reclamation that will be performed during the coming yeaz, 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 report and annual report man to this form. 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 Cazl V. Hill
Permittee Name: Beltway Paving Company
Address: 131 N. 35th Ave.
P.O. Box 3159
Greeley, CO 80634
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it [o this form along with your written report and map. Annual Report instructions are enclosed.
Signature of Corporate Officer or Owner
Date
M?PERMTI~h1A5TERDOCUMENTSNI-AF-OI