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iii iiiiiiiiiiiu iii s ~ <br />ANNUAL REPORT :. EI~fE® <br />_ F y 3.3 2000 <br />PERMITTEE NAME: Dorn Ready-Mix Corp <br />PERMIT NO.: M1974092 ' "' "~ ~ ~~ ~ ~eo~Y <br />OPERATION NAME: Barlow Pit <br />ANNIVERSARY DATE: October 31, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Morgan <br />According to C.R.S. 34-32-I 16(3)(a), 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 <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for the <br />year, if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note that nn adequately labeled map that clearly delineates and inckcdes the above elements may <br />since for n written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name: ~~~ E,/ ,/~W~ (./!'t/~ <br />Address: Aa, i3ox ~ 3G <br />~. ~ 7B / <br />Company: l0 <br />Phone No.: ~67 <br />Fax No.: (97D) ~s~C 7- 7~y3 <br />If there are additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />Signs re of Corporate Offi r, Owner Date <br />INSTRUCTIONS ON BACK <br />