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<br />~ r'"t. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />M-1990-021 <br />Virginia Acres <br />January 24, 2006 <br />$688.00 (Due on or before your anniversary ion of Mineials and Geology <br />Mesa <br />RECE6QIE® <br />SAN 2 5 1006 <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 date and 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 ym~r revised written anm~al rennrt and annual re~nrt maT to this fnrm_ Please note that an <br />adequately dabeied 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: Brent W. Kerr <br />Permittee Name: Oldcastle SW 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: (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 map. Annual Report instructions are enclosed. <br />~ 5,/~2~v.~" ly I-5 ,.nlv <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />