2006-04-17_REPORT - M2000151

• Permit No: M2000151
• IBM Index Class Name: Report
• Doc Date: 4/17/2006
• Doc Name: Annual Fee/Report/Map
• From: Fremont Paving & Red-Mix Inc.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

l~ 1t--
PERMIT ITIEE NAME:
PERMIT INO.:
OPERA ZION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
U ANNIiAi. FF.F, and RF.PiIRT RF,OiTF:ST
~/ Fremont Paving &Redi Mix, Inc.
M-2000-151
RECEIVED
APR 17 2006
McCumber Hill Pit ~
1~Division ~f Minerals and Geology
April 18, 2006
$688.00 (Due on or before your anniversary date)
Fremont
Accordirig 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 sulimit_ the annual fee, a report and map showing the extent_of_ current. disturbances_to.offected land;.
reclamation accomplished to date and during the preceding year, 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 for the year, if any.
irh Xnnr reviced written anneal report and anneal re~prt main to this form. Please note that an
labeled map that clearly delineates and includes the above elements may since for a written report.
ision~ records indicate the following permittee contact information. Please verify and make any necessary
Contact: Denise Gonzales
Name: Fremont Paving &Redi Mix, Inc.
P.O. Box 841
Canon City, CO 81215-0841
Phone Number: [phone]
Fax Nu I bar: [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.
of Corporate Officer, Owner, or Designee
Date