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c~M <br />RECEIVE <br />JAN i S 2006 <br />PERMITTEE NAME: Loveland Ready Mix Concrete, Inc. <br />llivisiou of Minerals and Geology <br />PERMIT NO.: M-2001-022 <br />OPERATION NAME: Green/Croissant Property Sand and Gravel Mine <br />ANNNERSARY DATE: January 16, 2006 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Weld <br />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 <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 yeaz, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach xpnr revised written annual re;~prf and annual report mare to this fnrm_ Please note that an <br />adequately labeled map that clearly delineates and inch~des the above elements may sufficefor a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Steve Fancher <br />Permittee Name: Loveland Ready Mix Concrete, Inc. <br />Address: P.O. Box 299 <br />Loveland, CO 80539 <br />Phone Number: (970) 667-2680 <br />Fax Number: (970) 667-0036 <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 />Si tur orpo to Officer, Owner, or Designee <br />,,,, /,? 2006 <br />Date <br />