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~- <br />PERMITTEE NAME: Oldcastle SW Group, Inc. dba United Companies of Mes ounty <br />PERMIT NO.: M-2002-110 ~~+sP ~f V~® <br />OPERATION NAME: 19 Road Pit FEB 2 8 20Q5 <br />ANNIVERSARY DATE: February 25, 2005 ,,. . <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) v~sio" of Minerals and Geology <br />COI-JNTY: Mesa <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />- occur ~Yuiing-the-upcoming year,-reclamation that-will be-performed-during_the coming_year,she~ates_for the_ <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written annual re~nrt and annnal report ma=n, to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Brent W. Ken <br />Permittee Name: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />Address: 2273 River Rd. <br />P.O. Box 3609 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4900 <br />Fax Number: (970) 243-5945 <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 reap. Annual Report instructions are <br />enclosed. <br />Signature of Corporate Officer, Owner, or esignee <br />.Q-g . ~ 5, a. o v s <br />Dale <br />M:~PERMIIUTASTERDOC[JMENTS~M-AF-04 <br />