REP41982

• Permit No: M1974004
• IBM Index Class Name: Report
• Doc Date: 3/21/2002
• Doc Name: 2002 Annual Report
• From: Mobile Premix Concrete Inc.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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RECEIVED
MAR 2 1 2002
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Division of Minerals and Geology
Mobile Premix Concrete, Inc.
M-1974-004
Specification Aggregates Quarry
February 15,2002
$688.00 (Due on or before your anniversary date)
Jefferson
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
shall submit the annual fee, a'report and ritap showing the extent of current disturbances [o affected land,
reclamation accomplished to date and during the preceding year, new dish~rbances that are anticipated to occur
during the upcoming year, reclamation that will be-performed during the coming year, the dates for [he beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach vour revised written annual report and annual report map to this form. 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 permit[ee contact information. Please verify and make any necessary
changes: .
Permittee Contact:. -Eric Reckentine
' ' . ~ Pecmittee Name: Mobile Premix Concrete, In'c.
Address:
Phone Number:
Fax Number:
1590 W. 12th Ave.
Denver, CO 80204
(303) 657-433®
[phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Signature of Corpor to Officer or Owner
i/~/a a-
bate
M:~PER MI"I'N-I ASTERDONMENTSUA-AF-OI