2007-01-19_REPORT - M1974041

• Permit No: M1974041
• IBM Index Class Name: Report
• Doc Date: 1/19/2007
• Doc Name: Annual Fee/Report/Map
• From: Lawrence Construction Company
• To: DRMS
• Media Type: D
• Archive: No

REC'~ DEG 0 6 2006
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE and REPORT REQUEST
/Lawrence Construction Company
"M-1974-041
Lawrence Pit
January 29, 2007
ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date)
COUNTY: Douglas
w~
.IJAN 1 g 2007
Divi In,n9 an ectarnation,
d Safety
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
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation accomplished to date and during the preceding yeaz, new disturbances that are anticipated to occur___
--- "during the upcoming year; reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
map. If no new disturbances or reclamation have occurred durinc the arevious year and no new chances to
the previous year's map are necessary. then no new map is required, provided that the Operator shall state
this in the Annual Resort. Please note that an adequately labeled map that clearly delineates and includes the
above elements may suff ce for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Bill Lawrence
Permittee Name: Lawrence Construction
Address: 9002 N. Moore Rd.
Littleton, CO 80125
Phone Number: [phone]
Fax Number: [phone]
If you have additiocomments and/or information that should be provided to the Division, please provide it
below or a)#gch it t ~s form along with your written report and map. Annual Report instructions are enclosed.
Signature Ef%Corpo~e Officer, Owner, or Designee
- IZ- Iii ~--
Date