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~~ <br />ANNiiAT. FF.F, and RF.PnRT RF,t7TTF.ST RE~E~ VE® <br />PERMITTEE NAME: Aggregate Industries - WCR Inc. JUN Q 1 <br />PERMIT NO.: M-2000-082 Division of Minerals and Geology <br />OPERATION NAME: E 8th Street Operation <br />ANNIVERSARY DATE: May 3, 2005 <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 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 ynnr revised written annual red nrt and annnal rppnrt maw to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since jor a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Mike Refer <br />Permittee Name: Aggregate Industries - WCR, Inc. <br />Address: 1707 Cole Blvd., Ste. 100 <br />Golden, CO 80401 <br />Phone Number: (303) 985-1070 <br />Fax Number: <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 />~°~ ~. G~ <br />Signature of Corporate Officer, Owner, or Designee <br />~ = 3/- a~ <br />Date <br />