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i- <br />ANNiiAi. FRF, and REPORT RF.OiiFST <br />PERMITTEE NAME: Lafarge West, Inc. RECE-VED <br />PERMIT NO.: M-1981-307 JUN 141003 <br />OPERATION NAME: Fountain Pit Ulvisinn e(Minerals and Geology <br />ANNNERSARY DATE: June 15, 2003 <br />ANNUAL FEE DUE: $688.00 (Due ou or before your anniversary date) <br />COUNTY: EI Paso <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 accomplished to datee a'nd 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 your revised written anneal rennrt and anneal report maw 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 permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Gary J. Tuttle <br />Permittee Name: Lafarge West, Inc. <br />Address: 1590 W. 12th Ave. <br />Denver, CO 80204 <br />Phone Number: (303) 657-4123 <br />If you have additional comments and/or information that should be provided to the Division, please provide i[ <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 />Date <br />M:~PERMITVv1ASTER DOCUMENTSVvI-AF-01 <br />