2003-11-13_REPORT - M1983013

• Permit No: M1983013
• IBM Index Class Name: Report
• Doc Date: 11/13/2003
• Doc Name: Annual Fee/Report Notice
• From: Lafarge West Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Lafarge West, Inc.
M-1983-013
Latham -Burkett Pit
November 15, 2003
$688.00 (Due on or before your anniversary date)
Mesa
FtECEIVE®
NOV 1 3 2003
Dirision ~f Minerals and Geobgy
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
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, [he dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ymrr revised written annual report and anneal rennrt m ~n to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffrce for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Pernuttee Contact: Eric Reckentine
Pertnittee Name: Lafarge West, Inc.
Address: 1400 W. 64th Ave.
Denver, CO 80221
Phone Number: [phone]
Fax-Number: ----'- ~ -!
If you have additional cornments 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
MiPERM ITVNASTERDOC UMENTSUA-AF-01