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A7 I -- :' A J T <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: -P Southway Construction Company, Inc. <br />PERMIT NO.: A- 1988 -087 <br />OPERATION NAME: Swede Corners Pit 'DEC 212009 <br />ANNIVERSARY DATE: January 13, 2010 -� - Division of Reclamation, <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) Mining and Safety <br />COUNTY: Saguache <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- disc- urbanees -that- are- anticipaf.ed-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 an nual report and annual report man 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: <br />Permittee Name: <br />Address <br />Phone Number: <br />Fax Number: <br />Ralph Martinez <br />Southway Construction Company, Inc. <br />117 White Pine Dr <br />Alamosa, CO 81101 <br />(719) 589 -5103 <br />(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 />4 - <br />Signature Corporate Officer, OwVer, or Designee <br />T9. 1F0T <br />Date <br />