REP44251

• Permit No: M1977534
• IBM Index Class Name: Report
• Doc Date: 1/31/2003
• Doc Name: Annual Report
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Mountain Aggregates, Inc.
M-1977-534
Empire Pit
January 30, 2003
$688.00 (Due on or before your anniversary date)
Clear Creek
JAN 3 ;1 2003
flivision of Minerals artd Geology
According [o C.R.S. 34-32.5-116 or C.R.S. 34-32-] 16, each year, on [he anniversary date of [he 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 distur ances t at are anUCtpated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active 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. 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:
Permiuee Contact: LeRoy Marquez
Permittee Name: Mountain Aggregates, Inc.
Address: P.O. Box 535
Castle Rock, CO 80104
Phone Number: [phone]
- Fax Number: _ [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 instmctions are enclosed.
Signature f Corp t fficer, Owner, or Designee
/- ~%- O.;
Date
M ~~PERM nN1ASTERD000M EMSVN-AE-01