2007-08-13_REPORT - M1984101

• Permit No: M1984101
• IBM Index Class Name: Report
• Doc Date: 8/13/2007
• Doc Name: Annual Fee/Report/Map
• From: Hard Rock Paving & Redi-Mix, Inc.
• To: DRMS
• Media Type: D
• Archive: No

r
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
P~
ANl'QUAL FEI~d PORT REQUEST
/Hard Rock Paving &Redi-Mix, Inc.
/M-1984-101
Chaparral Meadows Pit
August 13, 2007
O~
RECEIVEb
~IUG 19 2001
Division or Reclamation,
y Mining and Safety
$791.00 (Due on or before your anniversary date)
Park
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
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that aze anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginnirig--
ofactive operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
map. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to
the previous year's map are necessary, then no new man is required, provided that the Operator shall state
this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the
above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: John Paul Ary
Permittee Name: Hazd Rock Paving &Redi-Mix, Inc.
Address: P.O. Box 1720
Canon City, CO 81215-1720
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be
below or attach it to this f rm along with your written report and map.
S' afore of Corporate Officer, Owner, or Designee
provided to the Division, please provide it
Annual Report instructions are enclosed.
~-/0-07
Date