2006-11-22_REPORT - M1991035

• Permit No: M1991035
• IBM Index Class Name: Report
• Doc Date: 11/22/2006
• Doc Name: Annual Fee/Report/Map
• From: Lafarge West, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
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PERMITTEE NAME: ~ LLafarge West, Inc. R~

PERMIT NO
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1991
035 CEIVE'Q
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NOV
OPERATION NAME: Bluestone Pit ~Dtv~s1pn
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Mining a
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ANNNERSARY DATE: November 5, 2006 nd Safety
ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date)
COUNTY: Jefferson
According to C.R.S. 34-32.5-I 16 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~ihe preceding year, new-disturbances ttha-t are anticipated io 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 previous veer and no new chances to
the previous year's maa are necessary. then no new map is required, provided that the Operator shall state
this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the
above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Pennittee Contact: Mark A. Vigil
Permittee Name: Lafarge West, Inc
Address: 10170 Church Ranch Wy. Ste. 200
Westminster, CO 80021
Phone Number: [phone] ~~-' ~~-- ~~~ `/
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Signature of Corporate Officer, Owner, or Designee
Date