2004-06-25_REPORT - M2000032

• Permit No: M2000032
• IBM Index Class Name: Report
• Doc Date: 6/25/2004
• Doc Name: Annual Fee/Report/Map
• From: M.A. Concrete Construction Inc.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

SS$

REG-~~~~D
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNPJERSARY DATE
ANNUAL FEE DUE:
COUNTY:
M.A. Concrete Construction, Inc.
M-2000-032
Monument View Gravel Pit
July 14, 2004
$688.00 (Due on or before your anniversary date)
Mesa
JUN 2 5 P004
Division of Minerals & GaoloBY
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
reclamation accomplished to date and during the preceding yeaz, new disturbances that are anticipated to occur
during the upcoming yeaz, reclamation that will be performed doting the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written annnal re~nrt and annual rennrt main to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Martin Azcarraga
Permittee Name: M.A. Concrete Construction, Inc.
Address: 2323 River Rd.
Grand Junction, CO 81505
Phone Number: [phone]
Fax Number: [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.
/.l...i
Signature f Corporate Offic Owner, or signee
~ 'al-o~
Date