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ANNUAL FEE and REPORT REQUEST <br />PERMIT'I'EE NAME: Aggregate Industries -WCR, Inc. RG CG' VE® <br />PERMIT NO.: M-1989-120 AUG 16 X002 <br />OPERATION NAME: Platte Valley Operation Division of Minerals and Geology <br />ANNIVERSARY DATE: July 16, 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 yeaz, on the anniversary date of the permit, an operator <br />--- -shall-submit-the-annual-fee-a-report-and-map-showing-the-extent-of-current-disturbances-to-affected-land- - <br />reclamation accomplished [o 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, [he 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 reuort and annual resort mau 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: Patrick Ward <br />Permittee Name: Aggregate Industries -WCR, Inc. <br />Address: 3605 S. Teller St. <br />Lakewood, CO 80235 <br />Phone Number: (303) 985-1070 <br />Fax Number: <br />If 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 alrong~w~it,,hwyou/r written report and map. Annual Report instmctions are enclosed. <br />1 ~' ~ ~ `~~ '`~ T/1 <br />Signature of Corp rate Officer or Owner <br />~ ! y- ~ 2 <br />Date <br />M iPERM]'nMASTERDOCUM ENTSUvi-AF-01 <br />