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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Lafarge West, Inc. <br />M-1981-307 <br />Fountain Pit <br />June 15, 2006 <br />$688.00 (Due on or before your anniversary date) <br />EI Paso <br />RECEI~lEp <br />JUL 0 7 2006 <br />Division of Minerals and Cea;ayy <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 the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamatien accomplished to 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, the 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 anon 1 rennrt and anmial rep rn f maw to Chic form. Please note that an <br />adequately labeled map that clearly delineates and includes fhe above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Mark A. Vigil <br />Permittee Name: Lafarge West, Inc. <br />Address: 10170 Church Ranch Way, Suite 200 <br />Westminster, CO 80021 <br />Phone Number: (303) 657-4123 <br />Fax Number: (303) 657-4037 <br />~~--f~ ~ <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 along with your written report and map. Annual Report instructions are enclosed. <br />C~Ze.e~ ~ Df ~QIl~A rl G /'~ <br />Signature of Corporate Officer, Owner, or Designee <br />t~l~ ~~ <br />Date <br />