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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />ARS Sand & Gravel Co., LLC <br />M-1980-020 <br />Braley S&G Pit No 1 <br />July 15,2003 <br />RECF~~FD <br />~UL 0 3 p~ <br />Di v;,ion et IHinerah anE J~tDBY <br />$688.00 (Due on or before your anniversary date) <br />Douglas <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 <br />-- ~. shall submit the annual-fee, a- report:-and-map-showing-the-extent of- culTent-disturbances 4o-affected-land, -- - <br />- - -reclamatien-aeeomp&shed-to-date-and-during-the-preceding-year,-ncw-disturbances-that are-anticipated-to-occur <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 attach ~r revised written anneal red ort and anneal re~nrt m~ to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact-. I=ktve~.4esk€ercel- /I'1 i k e 3 ~w s ~..~ <br />Permittee Name: ARS Sand & Gravel Co., LLC <br />Address: 8505 W. Mtn. View Ln. <br />Littleton, CO 80125-000 <br />Phone Number: (303) 346-8280 <br />Fax Number: (303) 791-7405 <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 />g•¢ I - oo- 7935 <br />~~ . <br />Signature of Corporate Officer, Owner, or Designee <br />~o ~ U <br />Date <br />M:~PERMITU1ASTERDOCUM ENTSVN-AF-01 <br />