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<br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />M.A. Concrete Construction, Inc. <br />M-2000-032 <br />Monument View Gravel Pit <br />July 14, 2003 <br />$688.00 (Due on or before your anniversary date) <br />Mesa <br />RECEIVED <br />JUN 1 9 2003 <br />Division of Minerals and Geology <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 y~ytr revised written anneal report and annual renurt maT to this fnrm_ Please note that an <br />adequately labeled map that clearly delineates and includes the ahove elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Martin Azcarraga <br />Permittee Name: M.A. Concrete Construction, Inc. <br />Address: 2323 River Rd. <br />Grand junction, CO 81505 <br />Phone Number: {970) 243-3221 <br />Fax Number: (970) 243-9757 <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 />~l~QJ' <br />Si afore of Corpor Officer, Ow r, or Designee <br />~ - / 7-0~ <br />Date <br />M:iPERMI7IMASTERDOCUMENTSUd-AF-0 i <br />