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~~'~ <br />RECEIVEQ <br />JAN 2 6 2004 <br />Division of Minerals & GeeloBY <br />PERMITTEE NAME: Oldcastle SW Group, loc. dba United Companies of Mesa County <br />PERMIT NO.: M-1990-021 <br />OPERATION NAME: Virginia Acres <br />ANNIVERSARY DATE: January 24, 2004 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: 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 operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />- reclamation accbmplisfied-to~lat-e an8-during the-preceding year,-new disturbances thaf are anticipatedZO 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 yQnr revised written annnal ren~rt and annual report mad to this f~rm_ 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: -Rtchar' '~~ir- <br />Permittee Name: Oldcastle SW <br />Group, Inc. dba United Companies of Mesa County <br />Address: P. O. Box 3609 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4900 <br />Fax Number: y?o-~¢3- ~4-3~ <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 />~ ~ J <br />Signature of Corporate Officer, Owner, or esignee <br />D (~'1 <br />~js~ <br />M:\PERMI'MIASTERDOCUMENTSNI-AF-01 fjb ~/{~ <br />