REP02291

• Permit No: M1993041
• IBM Index Class Name: Report
• Doc Date: 9/9/2002
• Doc Name: 2002 Annual Report
• From: CEMEX Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

• ANNUAL FEE and REPORT REQUEST
PERMITTEENAME: CEMEX,Inc. REL+E~VEp
PERMIT NO.: M-1993-041
OPERATION NAME: Dowe Flats Mine SEP 0 9 2002
ANNNERSARY DATE: September 8, 2002 Division of Minerals and Geology
ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date)
COUNTY: Boulder
According [o C.R.S. 34-32.5-116 or C.R.S. 34-32-1 ]6, 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 [he 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 [he year, if any.
Please attach vour revised written annual report and annual resort map to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
• Permittee Contact: John Lohr
Permittee Name:
Address:
Phone Number;
Fax Number:
CEMEX, Inc.
P.O. Box 529
Lyons, CO 80540
[phone]
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, Owner, or Designee
Date
•
M:V'ERM17N9ASTERDOCUMENTSN1-AF-01