2005-10-24_REPORT - M1981132

• Permit No: M1981132
• IBM Index Class Name: Report
• Doc Date: 10/24/2005
• Doc Name: Annual Fee/Report/Map
• From: Valco Lamar Concrete Division
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
AN~NTIAT. FF.F, and REPORT RF.t7TTFST
' Valco Lamar Concrete Division
~NI-1981-132
Lamar West Pit
November 5, 2005
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$688.00 (Due on or before your anniversary date)
Prowers
-According-to C.R:S. 34-32-5-116-or-G:R-S.-34-32-116, 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 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 anmial rennrt and annnal rvpnrt man to this 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 permittee contact information. Please verify and make any necessary
olfangesi
Permittee Contact:
Permittee Name:
Wayne Adams
Valco Lamar Concrete Division
Address: P.O. Box 591
Phone Number:
Fax Number:
Lamar, CO 81052
[phone]
[phone]
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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.
Signature of Corporate Officer, Owner, or Designee
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Date
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M:~PERMI7IMASTERD000MENTSU-[-AF-04