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~_ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNiJAL FEE DUE: <br />COUNTY: <br />Lafarge West, Inc. <br />M-2001-090 <br />River Valley Resource <br />July 29, 2005 <br />$688.00 (Due on or before your anniversary date) <br />Routt <br />. __..~, <br />_, <br />CCT i ;; ZG~5 <br />- ..IcRV <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 disturhances 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 yeaz, if any. <br />Please attach ynnr revised written annual rennrt and annual rennrt man fn this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Eric Reckentine <br />Permittee Name: Lafarge West, Inc. <br />Address: 1400 W. 64th Ave. ~~~1D ChUYfh ~ZCIYILIn ~A)flll, ~U.I}~ ~~ <br /> I~esh ~~,ns~r~r, Co gc~oai <br /> Denver, CO 80221 <br />Phone Number: (303) 657-4330 <br />Fax Number: _ UD?t' (OCJ~I -' ~~ 37 <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 />~~ n~ ~ ~~ <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />