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<br /> ANNiiAi, FF.F, and RF.PnRT RF, iO rFST <br />~~~L: <br /> <br />PERMITTEE NAME: ~. ~ <br />Aggregate Industries - WCR <br />Inc. -" <br />PERMTI' NO.: , <br />M-1985-112 MAR p g ~ <br />OPERATION NAME: Loloff Mine ~Ivision a/ Mi <br /> nerals and <br />Geology <br />ANNNERSARY DATE: February 4, 2004 <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 pernrit, an operator <br />_ shall -submit -the annua]_fee,_a..report and -map-showing-the-extent of-current- disturbances-to-affccteu 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 yQnr revised written anmiai report and anm~al report m~ to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suJjice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: I tri rd <br />Permittee Name: Aggregate Industries - WCR, Inc. <br /> <br />Address: 1707 Cole Blvd Ste 100 <br />Golden, CO 80401-3220 <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 attd map. Annual Report instructions are enclosed. <br />Si tore of/C/orporate Officer Owner, esignee <br />Date <br />M:~PERMI'MIASTERDOCUMENTSNI-AF-0r ~ <br />i~ <br />