2003-09-10_REPORT - M1977361

• Permit No: M1977361
• IBM Index Class Name: Report
• Doc Date: 9/10/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
CEMEX, Inc.
M-1977-361
Silica Quarry
September 8, 2003
SEP 10 2003
Division ~f Minerals and Geology
$281.00 (Due on or before your anniversary date)
Boulder
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I 16, 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 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 ymir revised written anneal red nrt and anneal tenor[ m ~n to this form- Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice jot a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: John Lohr
Permittee Name: CEMEX, Inc.
Address: P.O. Box 529
Phone Number:
Fax Number:
Tf 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.
';~!Ef«~ ~ Lovttcon>td 6405. 57otJF LEtRSEE
Signature of Co rate Officer, Owner, or Designee
9/d/off
Date
Lyons, CO 80540
[phone]
M:\PE RM ITU1ASTERD000M ENTS\M-AF-01