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<br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Lafarge West, lne. RECEIVED <br />PERMIT NO.: M-1977-036 SEP 0 62002 <br />OPERATION NAME: Greeley Pit t)iuisien of Minerals and Geology <br />ANNNERSARY DATE: August 15, 2002 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Weld <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 pemut, an operator <br />_ _ shall submi[.the_annual_fee,._a renort_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 your revised written annual resort and annual resort mao to this form. Please note that an <br />adequately labeled 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 an}' necessary <br />changes: <br />Permittee Contact: Eric Reckentine <br />Permittee Name: Lafarge West, Inc. <br />Address: 1590 W. 12th Ave. <br />Denver, CO 80204 <br />Phone Number: (303) 657-4330 <br />Fax Number: (303) 657-4339 <br />L` 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 />~~~~t,r~ <br />Signature of Corporate Officer or Owner <br />3 D~-- <br />Date <br />M:NERMITU-f ASTERDOCUMENTSN9-AF-01 <br />