REP09902

• Permit No: M1974041
• IBM Index Class Name: Report
• Doc Date: 3/1/2007
• Doc Name: Annual Report
• From: Lawrence Construction Company
• To: DRMS
• Permit Index Doc Type: Annual Reclamation Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Lawrence Construction Company
M-1974-041
Lawrence Pit
January Z9, 2007
$$688.00 (Due on or before your anniversary date)
Douglas
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 yeaz, new disturbances that are anticipated to
occur during the upcoming yeaz, reclamation that will be performed during the coming yeaz, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this forth. The Annual
Report & Fee requirement is not met until we have received the following components: fee, report, and
associated map. If no new disturbances or reclamation have occurred durinc the previous year and no
new chances to the previous year's map are necessary, then no new map is required, provided that the
_Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly
delineates and includes the above elements may Buff ce for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Bill Lawrence
Permittee Name: Lawrence Construction Company
Address: 9002 N. Moore Rd.
Littleton, CO 80125
Phone Number: [phone]
Fax Number: [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. Armual Report instructions are enclosed.
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