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,r <br /> <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Aggregate Industries - WCR, Inc. RECE~VE~ <br />PERMIT NO.: M-1977-141 DEC 0 g 2002 <br />OPERATION NAME: Lyons Quarry Division of Minerals and Geology <br />ANNIVERSARY DATE: December 29, 2002 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Boulder <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 [o affected land, __ _ _ <br />reclamation accomphsh`ed-toaate and"dueing th'e 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 vour revised written annual report and annual report maa 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: Pat Ward <br />Permittee Name: Aggregate Industries - WCR, Inc. <br />Address: 3605 S. Teller St. <br />Lakewood, CO 80235 <br />Phone Number: (303) 716-5327 <br />Fax Number: <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 />i~,a ~ <br />Signature of Corporate Officer, Owner, or Designee <br />?.o Noy o a- <br />bate <br />M iPERMITUtASTERDOC UMENTSN~I-AF-01 <br />