2007-01-29_REPORT - M2001016

• Permit No: M2001016
• IBM Index Class Name: Report
• Doc Date: 1/29/2007
• Doc Name: Annual Fee/Report/Map
• From: Aggregate Industries - WCR, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
/Aggregate Industries -WCR, Inc.
~-2001-016
Fredstrom Resource
January 7, 2007
$$688.00 (Due on or before your anniversary date)
Boulder
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SAN 2 9 2007
Division of Raclama4lon,
~ron8 and 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-year; new-disturbances-that aze 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 yeaz, 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 previous year and no new chances to
the previous year's man are necessary, then no new map is required, provided that the Operator shall state
this in the Anuual Report. Please note that an adequately labeled map that clearly delineates and includes the
above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Connie N. Davis
Permittee Name: Aggregate Industries -WCR, Inc.
Address: 1707 Cole Blvd., Ste. 100
Golden, CO 80401
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
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Signature of Corporate Officer, Owner, or Designee
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Date