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IIIlillllliliili � c�°ok -°b2��1 <br /> ANNUAL FEE and REPORT REQUEST <br /> PERMITTEE NAME: Colorado Aggregate Company RECEIVED <br /> PERMIT NO.: M-1977-227 JAN 1 g 1001 <br /> OPERATION NAME: Mesita Hill Pit Division of Minerals and Geology <br /> ANNIVERSARY DATE: February 9,2001 <br /> ANNUAL FEE DUE: $688.00(Due on or before your anniversary date) <br /> COUNTY: Costil la <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 <br /> operator shall Submit the annual fee, a report and map showing the extent of current disturbances to affected <br /> land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br /> occur during the upcoming year, reclamation that will be performed during the tooting year, the dates for the <br /> beginning 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. Please note that an <br /> adequately labeled nrap that clearly delineates and includes the above elements rnav suffice for a written <br /> report. <br /> Division records indicate the following permittee contact information, Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Bob Cameron <br /> Permittee Name: Colorado Aggregate Company <br /> Address: 2255 Lava Ln. <br /> Alamosa, CO 81 101 <br /> Phone Number: (719) 589-4925 <br /> Fax Number: (719) 589-5559 <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 <br /> enclosed. <br /> L%t°' L04'ollu�- <br /> l/ <br /> Signature of Corporate Officer or Owner <br /> /-,25- 0 / <br /> Date <br /> M.TER.1ITWASTERDOCUMENTSV.I-AF-01 <br />