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PERMTI'TEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~ ANNUAL FEE and REPORT REOUES <br />All Rite Paving and Redi-Mix, Inc. <br />M-1999-005 <br />North River Pit <br />July 14, 2007 <br />~,-2.~~ <br />R~~~rV~ p <br />tJU~ 1 ~ 2007 <br />Ditdsio <br />Mining and ~~ ate. <br />ty <br />$$688.00 (Due on or before your anniversary date) <br />Otero <br />G~ I_ <br />1 <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 year, the dates far the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your 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 veer and no new chances to <br />the previous year's map 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 informaton. Please verify and make any necessary <br />changes: <br />Permittee Contact: Denise Gonzales <br />Permittee Name: ~ All Rite Paving and Redi-Mix, Inc. <br />Address: P. O. Box 1128 <br />La Junta, CO 81050 <br />Phone Number: (719) 383-2600 <br />Fax Number: (719) 383-2211 <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this f~oirm along with your written report and map. Annual Report instructions are enclosed. <br />'i>G;~~~ <br />Si ature of Corporate Officer, Owner, or Designee <br />~-i/- v ~ <br />Date <br />