2007-05-10_REPORT - M1995008

• Permit No: M1995008
• IBM Index Class Name: Report
• Doc Date: 5/10/2007
• Doc Name: Annual Fee/Report/Map
• From: Fremont Paving & Redi-Mix, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Fremont Paving &Redi-Mix, Inc.
M-1995-008
Florence Pit
May 13, 2007
RECEIVED
MAY 10 2007
Division of Reclamation,
MhNng and Safety
$$688.00 (Due on or before your anniversary date)
Fremont
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
-shalt-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 year, new disturbances theanticipated-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 durinc the previous vear and no new chances to
the previous year's map are necessary. then no new map is reouired. urovided 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: John P. Ary
Permittee Name: Fremont Paving &Redi-Mix, Inc.
Address: P.O. Box 841
Canon City, CO 81215-0841
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it -1
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.,,,,,..-~"~
ature of Corporate Officer, Owner, or Designee ~
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Date