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~~ ANNTIAT. FF.F, and REPORT RF.(~TiF.ST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Lafarge West, Inc. <br />M-1978-052 <br />Howe Pit <br />February 15, 2006 <br />$688.00 (Due on or before your anniversary date) <br />Adams <br /> <br />,f' FEB 1 E 2006 <br />//Diwsion of Minerals and Geology <br />According to C.R.S. 34-32.5-116 or C.R.5. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall-submit-the annual-fee,-a-report_and_map-showing-the-extent-of-current.. disturbances_to_affected_land, - <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual rennrt and anneal tenor[ ma= to thic form. Please note that an <br />adequately labeled map that clearly delineates and ir:cludes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Eric Reekentine <br />Permittee Name: Lafarge West, Inc. <br />Address: 10170 Church Ranch Way, Suite 200 <br />Westminster, CO 80021 <br />Phone Number: (303) 657-4330 ~- ~7- yG~ ~ <br />Fax Number: ~~-' fCJS7- Llt'J ~~ <br />If you have additional comments and(or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />~JL~c ~ 1[ 0 r~ I~.Q ~tn ,P ~~~ <br />Signature of Corporate Officer, Owner, or Designee <br />e~ //.~i /(iii <br />Date <br />