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<br />/~'LLa'yc' <br />YI'),~ <br />(~ ANNflAi, FF.F. and REPORT RF.OiTF.ST <br />PERMITTEE NAME: ~/Lafarge West, Inc. R~CE~ VEp <br />PERMIT NO.: ~ M-1986-159 vJUN 3 p Zppg <br />OPERATION NAME: Courtner Pit vision ~f Minerals and Geolaly <br />ANNIVERSARY DATE: June 15, 2006 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Pueblo <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 />reclamatien 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 ynnr revised written anneal regnrt and anneal rennrt m ~ to this form. please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee 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: (303j 657-4037 <br />~- ~7~~~ <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 />Signature of Corporate Officer, Owner, or Designee <br />(o ~~ /0~ <br />Date <br />