2010-10-06_REPORT - M1978271

• Permit No: M1978271
• IBM Index Class Name: REPORT
• Doc Date: 10/6/2010
• Doc Name: Annual Fee/Report/Map
• From: Asphalt Gravel Products, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME: P/ Asphalt Gravel Products, Inc.
PERMIT NO.: / M-1978-271
OPERATION NAME: Garrett Pit
ANNIVERSARY DATE: October 30, 2010
ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date)
COUNTY: Conejos
RECEIVED
,I/ OCT 0 6 2010
Division of Reclamatlon.
Mining & Safett{
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-preeeding year nnew-disturbances-that-are-anticipated-to-occur
during 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 changes to
the previous vear's man are necessarv, 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: Rock I. Southway
Permittee Name
Address:
Phone Number:
Fax Number:
Asphalt Gravel Products, Inc.
117 White Pine Dr
Alamosa, CO 81101
[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.
Signa re of Corporate f icer, Owner, or Designee
Date