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ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Southway Construction Company, Inc. <br />M-1988-087 <br />Swede Corners Pit <br />January 13, 2002 <br />RECEo~,'~;7 <br />JAN 3 0 2002 <br />'~ <br />Division afMinerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Saguache <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, 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 land, <br />reclamation accomplished to date and- during the preceding'yeaT, new'distu~ances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming yeaz, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report moo 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 pemtittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Kris DeGolyer <br />Permittee Name: Southway Construction Company, Inc. <br />Address: 117 White Pine Dr. <br />Alamosa, CO 8110] <br />Phone Number: (719) 589-5103 <br />Fax Number. ._. (719,)-589-5522 _ __ _. ~ ___ <br />If you have additional comments and/or information [hat should be provided [o [he Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions aze enclosed. <br />~.~ ~ .~, <br />Signature of Corporate Officer 9 Owner <br />~a~.~ <br />Date <br />M:IPERMR Vv1ASTERDOCUMENTSN-I-AF-01 <br />