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~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNPJERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Rocky Mountain Materials & Asphalt, Inc. <br />M-2000-052 <br />Coyote Ridge <br />September 11, 2004 <br />$688.00 (Due on or before your anniversary date) <br />Fremont <br />~~G~9~:`lE® <br />SEP 13 2004 <br />Division of Minerals & GaologY <br />.~J v~l <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 I <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"Eliot are anticipated"to occur - I <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attachymrr revised written annual rennrt and anmral re nrp f mgn to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since far a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Tom Smith <br />Permittee Name: Rocky Mountain Materials & Asphalt, Inc. <br />Address: 1910 Rand Ave. <br />Colorado Springs, CO 80906 <br />Phone Number: (719) 473-3100 <br />Fax Number: (719) 473-3109 <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 enclosed. <br /> <br />ware <br />