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r/ <br />PERMITTEE NAME: Fremont Paving &Redi-Mix, Inc. <br />PERMIT NO.: M-1988-093 <br />OPERATION NAME: Fremont Paving &Redi-Mix Pit <br />ANNIVERSARY DATE: March 3, 2003 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <br />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 _ <br />shall submit the annual fee, a report and map showing the extent of current disturbances to 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 rennrt and anneal rennrt m ~n to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: A°o h nallanrnni <br />Permittee Name: Fremont Paving &Redi-Mix, Inc. <br />,~-e n~ sc° ~o~tza,~~s <br />Address: P.O. Box 841 <br />Canon City, CO 81215-0841 <br />Phone Number: (719) 275-1280 <br />Fax Number: (719) 275-8897 <br />If you have additional comments and/or information that should be provided to the 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 />~~ <br />Signa a of Corporate Officer, Owner, or Designee <br />~~a~{ ~fl3 <br />Date <br />FiECEIVE® <br />FEB 2 6 2003 <br />Division of Minerals and Geology <br />MdPERMITVNASTERDOCUMENTSU-I-AF-01 <br />