2004-09-02_REPORT - M1993041

• Permit No: M1993041
• IBM Index Class Name: Report
• Doc Date: 9/2/2004
• Doc Name: Annual Fee/Report/Map
• From: CEMEX Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

• ANNTJAT. FF.F, and REPORT RoF.nTTF.ST
PERMITTEE NAME: CEMEX, Inc. R~(' ~' VE®
PERMIT NO.: M-1993-041 SEP 0 2 2004
OPERATION NAME: Dowe Flats Mine Oivisien of Minerals and Geolo9Y
ANNIVERSARY DATE: September 8, 2004
ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date)
COUNTY: Boulder
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
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, _
-------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, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written anneal red nrt and anneal re nn rt man to this form. Please note that an
adequately labeded map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
• Permittee Contact: John Lohr
Permittee Name:
CEMEX, Inc.
Address:
Phone Number:
Fax Number:
P.O. Box 529
Lyons, CO 80540
[phone]
If you have additional comments 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.
of Corporate Officer, Owner, or Designee
~.
•