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• <br />ANNUAL REPORT <br />PERMITTEE NAME: Fremont Paving & Redi-Mix Inc <br />PERMIT NO.: M-80-224 <br />OPERATION NAME: McKenzie Pit <br />ANNNERSARY DATE; October 27, 1999 <br />~ III IIIIIIIIIIIII III <br />~~ <br />~~ <br />O =~ECEIYED <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Fremont <br />OCT 12 1999 <br />- : of Minerab & GeplpDy <br />According to C.R.S. 34-32-1 l6(3)(a), each yeaz, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a repott and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, new <br />disturbances that are anticipated to occur during the upcoming yeaz, reclamation that will be <br />performed during [he coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach Your revised annual report map and written report to this <br />annual report. Plense note that on adegrrarely labeler! rrrup thrtt c/crrr'(e de~lMcatcs and <br />includes the above elements may suffice for n ~>>ritten report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: r~t,~ aa, t ar). <br />P.O. Box 841 <br />Company: Fromnnr Pavino A. Rarli-Miv 1nC <br />Phone No.: ( 719 ) 275-3264 <br />Canon Ci[y, Colorado 81215 <br />Fax No.: ( 719 ) 275-8897 <br />If there are additional comments and/or information that should be provided to the Division, <br />please provide it on a sepazate sheet and attach it to this report form along with your map and/or <br />written report. <br />/~--/-9~ <br />ignature of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />