2007-06-25_REPORT - M1992016

• Permit No: M1992016
• IBM Index Class Name: Report
• Doc Date: 6/25/2007
• Doc Name: Annual Fee/Report/Map
• From: Rocky Mountain Materials and Asphalt, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~ ~I I
ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
iRocky Mountain Materials & Asphalt, Inc.
`~M-1992-016
Penrose Ranch's
June 24, 2007
$$688.00 (Due on or before your anniversary date)
Fremont

~iJUN 252001
~6rvision of Reclamation,
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 during the preceding yeaz, new 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 far the year, if any.
Please attach vour revised written annual report and annual report man 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 durinc the urevious vear and no new chances to
the previous year's man 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 since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Ro e
Permittee Name: Rocky Mountain Mate ' is & Asphalt, Inc.
Address: 1910 Rand Ave.
Colorado Springs, CO 80906
Phone Number: [phone]
Fax Number: [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.
Date