2007-09-17_REPORT - M1993041

• Permit No: M1993041
• IBM Index Class Name: Report
• Doc Date: 9/17/2007
• Doc Name: Annual Fee/Report/Map
• From: CEMEX, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

SEP-06-200T 10:25AM FROM-DIV RECLAMATION MINING & SAFETY 3036326102
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
R~ ~ ~P-C
ANNUAL FEE and REPORT REQUEST
CEME7C, Inc.
M-1993-041
Dowc Flats Mine
September 8, 2007
T-A06 P.005/010 F-251
RECENED
~} SEP 17 2001
y Dlvlsbn of ReGamaOon,
V Mining and Safety
55791.00 (Due on or before your anniversary date)
Boulder

According to C.R.S. 34-32.5-116 or C.R.S. 3432-116, each year, on the anniversary date of the permit, an operator
shall submit the annual fee, a repoR 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 vour revised written annual report and annual report map to this form. The Aaaual Report
& Fee requirement is not met until we have received the following components: fee. report, and associated
mRD. If ao new disturbances or reclamation have occurred durint the previous vest and no new changes to
the previous vest's map are peeessarv. then no new map is required, provided that the Operator shall state
this in the Anpoal Report. Please note tha! an adequately labeled rnap drat clear/y delineates and includes the
shove elements may suffice jot a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Petmittee Contact: Patrick Fischer
Permittee Nome:
Address:
CEMEX, Inc.
P.O. Box 529
Phone Number:
Fax Number:
Lyons, CO 80540
[phone]
[phone]
If you have additional comments andlor 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 aze enclosed.
v ~ v
Signature of Corporate Officer, O er, or Designee
Date '