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=• <br />r <br />~~~T <br />ANNUAL FE and REPORT REQUEST <br />PERMITTEE NAME: 'Nalco Canon City Concrete Div. ~. <br />PERMIT NO.: `~M-1977-559 <br />a~..-1 <br />OPERATION NAME;: Canon City East Pit EB 2 0 Our <br />ANNIVERSARY DATE: February 22, 2008 ~ision of Fteciamation; <br />Mining and Saf®ty <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <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 ~subrnit-the annual fee,-a report-arid map sliowiig the-~tent-of-cun•ent 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 coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach. vour revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the urevious year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />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: F:andy Symons <br />Permittee Name: Valco Canon City Concrete Div. <br />Address: P.O. Box 669 <br />i'30 S. Mackenzie <br />(:anon City, CO 81215-0669 <br />Phone Number: (719) 275-7441 <br />Fax Number: (719) 275-7470 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below attach it to this form along with your written report and map. Annual Report instructions are <br />encl s <br />if . V ~~ <br />Signature f Corpo to O facer, Owner, or Designee <br />r L a00 ~ <br />Date <br />M:~PERMITUVIASTERDOCUMEi~1TS~M-AF-04 <br />