2003-01-23_REPORT - M1974041

• Permit No: M1974041
• IBM Index Class Name: Report
• Doc Date: 1/23/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECElVE®
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Lawrence Construction Company
M-1974-041
Lawrence Pit
January 29, 2003
JAN 2 3 2003
Division ff Minerals and Gealagy
$688.00 (Due on or before your anniversary date)
Douglas
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
__sha11-suhmit_theannual_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 ynnr revised written anneal report and anneal rennrt man to thic form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following pemtittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Bill Lawrence
Permittee Name: Lawrence Constmction Company
Address: 9002 N. Moore Rd.
Littleton, CO 80125
Phone Number: [phone]
---Fax Number: - - [phone]--- - -
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
gnature of Corporate Officer, Owner, o~ esignee
/~~~, 3
Date
M:V'ERM I"INIASTERDOCUM ENTS WI-AF-01