2008-10-23_REPORT - M1980224 - Laserfiche WebLink

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PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: ANNUAL FEE and REPORT REpUEST 4 Fremont Paving & Redi-Mix Inc -*'M-1980-224 McKenzie Pit % \t October 27, 2008 . CT 2 5 $$791.00 (Due on or before your anniversary date) Fremont 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 shall submit the annual fee, a report and map showing the extent of current disturbances to, affected land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur during the upcoming year;- reclamation "th'at -will-be performed-during-the-coming-year; the-dates-for-the-beginning- of active operations, and the date active operations ceased for the year, if any. Please attach your revised written annual report and annual report may to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated map. If no new disturbances or reclamation have occurred during the previous year and no new changes to the previous vear's man are necessarv, then no new man is reauired. provided that the Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: John Paul Ary Permittee Name: Fremont Paving & Redi-Mix Inc Address: P.O. Box 1720 Canon City, CO 81215 Phone Number: (719) 275-1280 Fax Number: (719) 275-8897 If you have additional comments and/or information that should be provided to the Division, please provide it below or attach i o this f along with your written report and map. Annual Report instructions are enclosed. Si a e of Corporate Officer, Owner, or Designee Date