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<br />• ~IIII~II~II~~I~IIII <br />ANNUAL REPORT <br />PERMITTEE NAME: Centennial Materials, Inc. <br />PERMIT NO.: M-76-009-1IR <br />OPERATION NAME: Menzer Quarry <br />ANNIVERSARY DATE: December 31, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: El Paso <br />~~ <br />a``'+ <br />RECEIVED <br />U k f, 0 0 1999 <br />nivision of N inerah & Geology <br />According to C.RS. 34-32.5-116(3)(a), each year, on the anniversary date of the permit, an operator <br />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 <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ceased. for the year, <br />if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />dote t{:at an adequately labeled map t{wt clearly delineates and includes the above eleme~tts may <br />suffice for a written report. <br />Please type of print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: Scott Davis Company: Centennial Materials <br />Address:: 2635 Delta Drive Phone No.: (719 1 392-4207 <br />Colorado Springs, CO 80910 Fax No.:~ 719 1392-4245 <br />If there are additional comments and/or information that should be provided to the Divisio~a, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />~^~'~L•yL~~ ~~ ~'-~s•.t:,~i.6' 12-0-99' <br />Signature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />