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<br />-~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~I~ I~~II~II~II~~'~~ <br />ANNUAL FEE and REPORT REQUEST <br />Sterling Redi-Mix Company <br />M-1986-147 <br />Harley Pit 1 <br />December 2, 2001 <br />RECEIVED <br />I~'nlt 2 7 7UUt <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Logan <br /> <br />According to C.R.S. 34-32.5-1 16 or C.R.S. 34-32-1 l6, 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 that are anticipated to occur <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 reuort map to this form. Please note that an <br />adequately labeled rnap that clearly delineates and includes the above elements may since for n written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: William G. Lauer <br />Permittee Name: Sterling Redi-Mix Company <br />Address: P.O. Box 1908 <br />Sterling, CO 80751 <br />Phone Number: (970) 522-9725 <br />Fax Number: - - - <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 />i r a~-o~ <br />Date <br />M:W ERM mM ASTERDOCUMENr5U1~AF-0 f <br />