ENFORCE22662

• Permit No: M1977361
• IBM Index Class Name: Enforcement
• Doc Date: 10/16/2006
• Doc Name: Inadequate Letter
• From: DRMS msr
• To: CEMEX, Inc.
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
CEMEX, Inc.
M-1477-361
Silica Quarry
September S, 2006
$$281.00 (Due on or before your anniversary date)
Boulder
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an
operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected
land, reclamation accomplished to date and during the preceding yeaz, new disturbances that aze 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 yeaz, if any.
Please attach vour revised written annual report and annual resort moo to this form. The Anneal
Report & Fee requirement is not met until we have received the following components: fee. report, and
associated moo. If no new disturbances or reclamation have occurred durine the previous veer and no
Operator shall state this in the Annual Report. Please note that an
delineates and includes the above elements may since for a written report.
map
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Patrick Fischer
Permittee Name:
Address:
Phone Number:
Fax Number:
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Signature of Corporate Officer or Owner
CEMEX, Inc.
P.O. Box 529
Lyons, CO 80540
[phone]
Date