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l1 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNTiAT. FF.F, and RFP(1RT RF.nTiF.ST <br />r <br />~. <br />Ready Mixed Concrete Company ~~Y 2 ~ ~~~~ <br />M-2001-046 Divisian of kti„arais & fxcolopy <br />Nix Sand & Gravel Mine <br />ANNNERSARY DATE: May 30, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: 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 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 yeaz, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach ymrr revised written annnal rpmnrt and anmral rernrl martn this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Bill Timmons <br />Permittee Name: Ready Mixed Concrete Company <br />Address: 4395 Washington St. <br />Denver, CO 80216 <br />Phone Number: (303) 659-0630 <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 />~~~~ <br />`Signature o Corporate Officer, Owner, or Designee <br />~o o?ov~ <br />Date <br />~b~ <br />