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III IIIIIIIIIIIIIIII <br />999 <br />ANNUAL FEE and REPORT REQUEST RECEIVED <br />SEC ~ 5 Z00\ <br />PERMIT NO NAME: M-1997R-O15y Mix OtxtstoaotMtneta\58opGea\o9~ <br />OPERATION NAME: Elrick Pit <br />ANNIVERSARY DATE: December 19, 2001 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Washington <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-1 16, each year, on [he anniversary date of [he permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances [o 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 farm. Please note that an <br />adequately labeled Wrap that clearly delineates and includes the above e[ernents Wray srt~ce for n written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Jill Darrell <br />Permittee Name: Akron Ready Mix <br />Address: <br />Phone Number: <br />Fax Number: <br />100 S. Cedar <br />P.O. Box J <br />Akron, CO 80720 <br />(970)345-2003 <br />(9701 "ta5-7a>st <br />~~b - 3tJS-7o0„~ <br />If you have additional comments and/or information that should be provided to [he 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 />/.~ ~iv~Lt¢r <br />Si ture of Corporate Officer or Owner <br /> <br />Date <br />7~.,-0 ~Y s ~ too ~~ w {-+~ -fn GQc~ <br />6,~.-r ~ r~t~ r~II ~.~-- -~-~ s~ ~s <br />O rI A'f H~ Su. (pttu Gl~-a' <br />M ~PERMRV.7ASTERD000MENTSNI~AF-01 <br />