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<br />ANNUAL REPORT <br />PERMTfTEE NAME: Dorn Ready-Mix Corp <br />PERMIT NO.: M-1974-092 <br />OPERATION NAME: Barlow Pit <br />ANNNERSARY DATE: October 31, 2000 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $688.00 <br />COUNTY: Morgan <br /> <br />•r~~~ f~•~~~ <br />t^_~ <br />~, ,t•,,, <br />,: ~:. . <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversazy date of the permit, an operator shall <br />submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during [he preceding year, new disturbances that aze anticipated <br />to occur during the upcoming year, reclamation that will be performed during the coming year, the <br />dates for the beginning of active operations, and [he date active operations ceased for the year, if any. <br />Please attach your revised annual report map and written resort to this annual resort. Please <br />note that an adequately labeled map t/tnt c[enrly delineates and incktdes the above elements may <br />since for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: n <br />ContactName:~~/,[6 a/ L w/ Company: ~O/l~• <br />Address: • ~' Phone No.:~70 ) gGT' Z~~ <br />`:~ ~oite e- ~ 7C~ ~ FAX No.: (91~) <LrL=7S~Y.3 <br />e-mail: --~ <br />If there aze additional comments and/or information [hat should be provided to the Division, please <br />provide it on a sepazate sheet and attach it to this report form along with your map and/or written <br />report. <br />Sign re of Corporate Off er, or Owner Date <br />INSTRUCTIONS ON BACK <br />M'1PERAf IIIMASTERDOCUMENTSVd-AF-01 <br />