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1 ~- <br /> ANNUAL FEE and REPORT REQUEST RECEIVED <br /> ocr ~ 5 2002 <br />PERMITTEE NAME: Lafarge West, Inc. <br /> Division of Minerals and Geology <br />PERMIT NO.: M-1980-131 <br />OPERATION NAME: Bunn Ranch Pit <br />ANNIVERSARY DATE: November 15, 2002 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Moffat <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 permit, an operator <br />shall submit [he annual fee, a report and map showing [he extent of current disturbances to affected land, <br />. reclamation-accomplished-to date-and during the-preceding-year,-new disturbances that aFe an"ticipated 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 vour revised written annual reuort and annual reuort man 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 any necessary <br />changes: <br />Permittee Contact: Gary J. Tuttle <br />Permittee Name: Lafarge West, Inc. <br />Address: 1590 W. 12th Ave. <br />Phone Number: <br />C Fax Number: <br />Denver, CO 80204 <br />(303)657-4123 <br />If you have additional comments and/or information that should be provided to the Division, please provide i[ <br />below or attach it to this form along with your written report and map. Annual Report instructions aze enclosed. <br />~'1'. ~2 1715 <br />Signature Corp r to Officer, Ow er, or Designee <br />lu .l ~~ <br />Date <br />M:~PERMnwIASTERD000MENTS~M-AF-01 <br />