2002-01-03_REPORT - M1999034

• Permit No: M1999034
• IBM Index Class Name: Report
• Doc Date: 1/3/2002
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

l
PERM[TTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:

ANNUAL FEE and REPORT REpUEST
Aggregate Industries -WCR, Inc.
M-1999-034
Cooley Reservoir & Fulton Wildlife Area
September 9, 2001
``CJ
RECEIVED
JAN 0 3 2001
Division of Minerals and Geology
$688.00 (Due on or before your anniversary date)
Adams
According to C.R.S. 34-32.5-I 16 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 [he preceding year, new disturbances that are anticipated [o 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. P/ease note that an
adequately labeled amp that clearly delineates and includes the above elements may suffice for n written report.
Division records indicate [he following perntittee contact information. Please verify and make any necessary
changes:
Pemtittee Contact: Patrick Ward
Pemtittee Name: Aggregate Industries -WCR, Inc.
Address: 3605 S. Teller St.
Lakewood, CO 80235
Phone Number: [phone]
Fax Number:
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach i[ to [his form along with your written report and map. Annual Report instructions are enclosed.
~~>~~ ~ ~~
Signature of Corpora e Officer or Owner
1 l 2"1 O
Date
M ~PERMI'MIASTER D(XUMENrSNt-AF-01