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Ramsey County <br />OFFICE OF THE COUNTY AUDITOR <br />AGGREGATE REMOVAL TAX REPORTING FORM <br />(Please type or print) <br />1. Name of Operator: <br />2. Address: <br />3. Reporting period covered by this report (check one): <br />_ January 1 - March 31, 19_ April 1 - June 30, 19_� <br />July 1 - September 30, 19 1 - December 31. 19_ <br />SCHEDULE A <br />PLEASE COMPLETE THE FOLLOWING SCHEDULE. USE ADDITIONAL SHEETS IF NECES- <br />SARY AND ATTACH TO THIS FORM. <br />Name or Location of pit, <br />quarry, or deposit from <br />which aggregate was re- <br />moved (include property <br />ID or parcel number) <br />Owner of pit. <br />quarry, or <br />deposit <br />Total cubic yards /tons <br />removed <br />Complete line 4 and /or line 5: <br />4. Total number of cubic yards of aggregate removed during this reporting <br />period: cubic yards x 5.10 • <br />Amount of Tax <br />5. Total number of tons of aggregate removed during this reporting period: <br />tons x 5.07 • <br />6. TOTAL TAX DUE (add amounts on lines 4 and 5) <br />7. If any of the aggregate renov <br />from the extraction site to t <br />portatton other than a highw: <br />low. <br />Amount of Tax <br />Total Tax Due <br />- - -0•d 'hove was shipped directly <br />or other mode of trans - <br />complete Schedule B be- <br />5S) <br />