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<br />ANNUAL REPORT <br />PERMITTEE NAME: Asphalt Paving Company <br />PERMIT NO.: M-74-OS6 ~~ <br />OPERATION NAME: Ralston Quarry CE~VE~ <br />ANNIVERSARY DATE: July 24, 1999 JUG 22 1998 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 ~rorsr°nOtMrne2M & Ge°I°gp <br />COUNTY: Jefferson <br />According to C.R.S. 34-32-1 16(3)(a), each year, on [he anniversary date of [he permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for [he yeaz, if any. <br />Please attach your revised annual report map and written report to this <br />annual report. Please note that nn adequately labeled nrap that clearly delineates and <br />includes the above elements rrrny suffice for n written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: .~~1-rvtES K- ~1~a.~N~nr4~/tCompany: rr rs~h,v~~ ~Avin.ti ~-o <br />Address: f `lff0~ lrJ. `I`'li'`` /}-vr'NVE PhoneNo.:(303 ) 2~h-6~// <br />~r~~t~ C,d FsU4d~ Fax No.: (303 ) 27~i-6x16 <br />--, <br />If there are additional comments and/or information that should be provided [o [he Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />t~ // ~ <br />Signature of Corporate Officer, or Owner Dat <br />INSTRUCTIONS ON BACK <br />