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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />ANNdL"FElff an REPORT REQUEST <br />All Rite Paving & Redi Mix, Inc. <br />1,-1987-079 <br /> <br />dAUG 2 0 2009 <br />OPERATION NAME: Lamar Pit <br />ANNIVERSARY DATE: September 2, 2008 ((/ <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Prowers <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 />-° - reclamation- accomplished -to date and -during-the-preceding-year,-new- 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 vear's map are necessarv, then no new map is required, provided that the Operator 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: John Paul Ary <br />Permittee Name: All Rite Paving & Redi Mix, Inc. <br />Address: P.O. Box 1720 <br />Canon City, CO 81215-0566 <br />Phone Number: (719) 275-1280 <br />Fax Number: (719) 275-8897 <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 ong with your written report and map. Annual Report instructions are enclosed. <br />Sign re of Corporate Officer, Owner, or Designee <br />00-?6 oW <br />Date