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1?4 ??- I*+-- (4-r <br />PERMITTEE NAME: Southway Construction Company, Inc D <br />PERMIT NO.: X141-1987-012 ?/MAY 12 2010 <br />OPERATION NAME: King Pit Div ian or R? c4m"on, <br />ir? and Safety <br />ANNWERSARY DATE: May 27, 2010 AAin <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Alamosa <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 year's map are necessary, 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 sufce 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 />4?au <br />Signa re of Corporat Off r, Owner, or Designee <br />Date <br />ANNUAL FEE and REPORT RE UEST <br />.