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<br />esc <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~i -~r~~ <br />La rge West, Inc. <br />981-088 <br />McCoy Pit <br />RECEI!/EC <br />NOV 3 0 2005 <br />November 15, 2005 ~Diuision of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Routt <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 drsturbances to affected-land-- <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during [he 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 ymrr revised written annnal rennrt and annnal re~nrf main 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 pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Eric Reckentine <br />Permittee Name: Lafarge West, Inc. <br />Address: 10170 Church Ranch Way, Suite 200 <br /> Westminster, CO 80021 <br />Phone Number: (303) 657-4330 c~-~"~ry~~-~~~ <br />Fax Number: (303) 657-4037 <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />C~ ~ D ~ .~ n`~tn. ~ <br />Signature of Corporate Officer, Owner, or Designee <br />`~Ocf2ln ~1- ~Q ~,G~~ <br />Date <br />