2008-11-04_REPORT - M1998059

• Permit No: M1998059
• IBM Index Class Name: REPORT
• Doc Date: 11/4/2008
• Doc Name: Annual Fee/Report/Map
• From: L & L Ready Mix
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Email Name: ECS
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
a1<
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Ar- ;' , P
ANNUAL FEE and REPORT REOUEST
L & L Ready Mix
A 4
v/M-1998-059
Sunny Dale Farm Pit
September 15, 2008
$791.00 (Due on or before your anniversary date)
Phillips
11 t
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CL J;rf1
NOV 0 `i 2000
Division o? rwelamation,
Mining and Safety
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-dur-ing--the-piece -ding year, -new-distur-bances-that-are-anticipated-to-occur-dur-ing the-upcoming--- --
year, reclamation that 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 map 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 chances to the previous
year's map are necessary, then no new map is required, 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: Laurine Koellner
Permittee Name:
Address:
L & L Ready Mix
P.O. Box 218
Phone Number:
Fax Number:
Haxtun, CO 80731
[phone]
[phone]
If you have additional comments and/or information that should be provided to the Division, please provide it below or
attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Signature of Corporate Officer, Owner, or Designee
/U-3iOd
Date