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~~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />(/ ANNTiAi, FF.F, and RF.PnRT RF.(iTiF.ST <br />// Lafarge West, Inc. <br />M-1981-307 <br />Fountain Pit <br />June 15, 2006 <br />RECEI~F~p <br />~ 'JUN 3 0 ~_ ; <br />Division ~f Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />EI Paso <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 />rcclamation 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 ym~r revised written anm~al rennrt and annual re nrt m,1p to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a wrttten report. <br />Division records indicate the following pemuttee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Mark A. Vigil <br />Permittee Name: Lafarge West, Inc. <br />Address: 10170 Church Ranch Way, Suite 200 <br /> Westminster, CO 80021 <br />Phone Number: (303) 657-4123 ~~ !'~~'~-~ ~ <br />Fax Number: (303) 657-4037 <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 />(_.e.t-ems L D f ~IZ~ /L_@ <br />Signature of Corporate Officer, Owner, or Designee <br />~'~ <br />Date <br />