2009-02-19_REPORT - M1977559

• Permit No: M1977559
• IBM Index Class Name: REPORT
• Doc Date: 2/19/2009
• Doc Name: Annual Fee/Report/Map
• From: Valco Canon City Concrete Div.
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Email Name: BMK
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
b Of X OP-
ANNUAL FED an" d REPORT REQUEST
k'Val Canon City Concrete Div.
Canon City East Pit
February 22, 2009
1?--? ? /Slay
RECEwEO
JAN 0 8 2009
Division of Reciamation,
Mining and Safely
II (iF ®
?g 19 ?n0?
$$791.00 (Due on or before your anniversary date) ivision of Reclamation,
w&Q and Safety
Fremont
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 shall -submit the annual-fee, a_re.port._and_map showing the extent-of current disturbances to affected --
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. The Annual
Report & Fee requirement is not met until we have received the following components: fee, report, and
associated map. If no new disturbances or reclamation have occurred during the previous year and no
new changes to the previous year's map are necessary, then no new map is required, provided that the
Operator shall state this in the Annual Report. 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: Randy Symons
Permittee Name: Valco Canon City Concrete Div.
Address: P.O. Box 669
730 S. Mackenzie
Canon City, CO 81215-0669
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 a it to this form along with your written report and map. Annual Report instructions are
Signature of
Date
, Owner, or Designee
M: \PERMIT\MAS TERDOCUMENTS\M-AF-04