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~'c ~ <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />J <br />A <br />F E and REPORT REQUEST <br />rSouthway Construction Company, Inc. <br />~1VI-1987-013 <br />Burton Pit <br />May 6, 2008 <br />$$323.00 (Due on or before your anniversary date) <br />Rio Grande <br />~~ <br />~~~' o ~~ ~~~~ <br />~~, ~ o <br />~~~~n ct~ ZD 8 <br />n9 d nasal ~~f~~ <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 current disturbances to affected land, <br />-°~reclamal3"ori a,cc~mplslied-tom dafe-and~~xriirg~the~prec~ding=year; rrew=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 your revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's map are necessary, then no new mau is required, urovided that the Ouerator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Ralph Martinez <br />Permittee Name: Southway Construction Company, Inc. <br />Address: 117 White Pine Dr <br />Alamosa, CO 81101 <br />Phone Number: (719) 589-5103 <br />Fax Number: (719) 589-5522 <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 />Signature of Corporate Offi ,Owner, or Designee <br />Date <br />