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~_ <br />PERMITTEE NAME: Hard Rock Paving &Redi-Mix, Inc. RECEIVED <br />PERMIT NO.: M-1984-101 AUG <br />OPERATION NAME: Chaparral Meadows Pit ~ ~ 2003 <br />Diuisian ~/Minerals and Ceolag~ <br />ANNIVERSARY DATE: August 13, 2003 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Park <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 />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 [he date active operations ceased for the year, if any. <br />Please attach 3 nor revised written annual red nrt and anneal red nrt 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 permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: John Paul Ary <br />Permittee Name; Hard Rock Paving &Redi-Mix, Inc. <br />Address: P.O. Box 1720 <br />Canon City, CO 81215-1720 <br />______-~honaNumber (719)225=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 />Signs e~o~~wner, or Designee <br />8 //- <br />Date <br />M:IPERMITMASTERD000MENTSN-I-AFAI <br />