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/, III IIIIIIIII IIII III <br />' 999 <br />/. , <br />~ RECEIVED <br />ANNUAL FEE and REPORT REQUEST NOV O 5 2OOi <br />Division of Minerals and Geology <br />PERMITTEE NAME: Valco Lamar Concrete Division <br />PERMIT NO.: M-1981-132 <br />OPERATION NAME: Lamar West Pit <br />ANNNERSARY DATE: November 5, 2001 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Prowers <br />According [o C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of [he 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 during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual resort and annual report map to this form. Plense note that an <br />adequately lobe/ed map that c/early delineates and includes the above elements mny since for a written <br />report. <br />Division records indicate [he following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: George S. Gotto ~ <br />Permittee Name: Valco Lamar Concrete Division <br />Address: P.O. Box 591 <br />Phone Number: <br />Fax Number: <br />Lamar, CO 81092 <br />(719)336-2223 <br />(719)336-2224 <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 <br />enclosed. <br />~~ <br />Signature of Corporate Officer or Owner <br />Date <br />M:~PER f.71TMASTERD000MErlrSN1~AF~01 <br />