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RECEIVED- <br />APR 3 0 2002 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Bestway Paving Company <br />M-1977-315 <br />Pit No. 1 <br />Apri123, 2002 <br />Division of Minerals and Geology <br />$688.00 (Due on or. before your anniversary date) <br />Weld <br />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 <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />-recl~nation"accurrspiisheu to-datc'asidziuring-thz-ps~ezdiug-year; naw-disturba7rces-chat are-antic ipated'to-eccur--- <br />during the upcoming year, reclamation that will be performed during [he coming yeaz, [he 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 resort and annual report map 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 permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Carl V. Hill <br />Permittee Name: Bestway Paving Company <br />Address: 131 N. 35th Ave. <br />Greeley, C 0634 <br />~p~~~ <br />~I~L1- t.c~ ~ )(off <br />Phone Number: (970) 353-1654 <br />- Fax Nurttber: _ (970) 353_5089 _ ~ ~ ~ _ ,4_ <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 />Signature of Corporate Officer or Owner <br />~-a~ ,a Z <br />Date <br />nu;,~.~,,g c ~ ~-~ ~c f- had <br />~>V ~C~b n-~z-n~c~c~ ~ ~ ~lu~.e <br />M:~PERMn1MA5TERD000M ENTSUI-AF-01 <br />