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f/D'~ <br />r `- <br />I" <br />ANN~ FIE an~ i PORT REQUEST <br />PERMITTEE NAME: ~ All Rite Paving &Redi-Mix, Inc. ~-, 1. ~~ s , .~ <br />, <br /> U~.: ,,~ <br />~ ~ <br /> <br />PERMIT NO.: <br />~I-1987-079 , <br />~D <br />OPERATION NAME: Lamar Pit ~' ^ 2[70] <br />ANNNERSARY DATE: September 2, 2007 ~ ~''="^^~an, <br /> `-~ <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Prowers <br />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 <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 year, new disturbances iliat are anticipated to occui ---- <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous vear and no new chanties to <br />the previous year's man are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: John Paul Ary <br />Permittee Name: All Rite Paving &Redi-Mix, Inc. <br />Address: P.O. Box 1720 <br />Canon City, CO 81215-0566 <br />Phone Number: (719) 275-1280 <br />Fax Number: (719) 275-8897 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />~~ <br />ature of Corporate Officer, Owner, or Designee <br />07 <br />Date <br />