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s <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Builders Aggregate Company, Inc. <br />M-1981-112 <br />Builders Aggr Pit <br />September 1, 2002 <br />RECEIVED <br />AUG 2 7 pppp <br />Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Morgan <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 />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated [o 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 your revised written annual report and annual report map to 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: James S. Miner <br />Permittee Name: Builders Aggregate Company, Inc. <br />Address: 915 W. Beaver Ave. <br /> F[ Morgan, CO 80701 <br />Phone Number: (970) 867-6334 <br />Fax Number: (970) 542-0832 <br />If you have additional comments and/or information that should be provided [o the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instmctions are enclosed. <br />ature of Corporate Officer, Owner, or Designee <br />~ ~O - ~~ <br />Date <br />M:NERMINNASTERD000MENTSN-I-AF-01 <br />