2007-03-28_REPORT - M2000016 - Laserfiche WebLink

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PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE ANNUAL FEE DUE: COUNTY: ANNUAL FEE and REPORT REQUEST Lafarge West, Inc. M-2000-016 Riverbend Operation March 26, 2007 $$688.00 (Due on or before your anniversary date) Weld 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 - --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 vour revised written annual report and annual report map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated IDap. If no new disturbances or reclamation have occurred durinc the previous vear and no new chances to the previous year's man are necessary, then no new map is required, provided that the Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above elements may since for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Mark A. Vigil Permittee Name: Lafarge West, Inc, Address: 10170 Church Ranch Way, Suite 200 Westminster, CO 80021 Phone Number: (303) 657-4123 ~~~` 7- ~/{/~~ Fax Number: (~JO~~-~ ~ / - `-YD~j7 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. ~ ~c ~ ~~ ~ Signature of Corporate Officer, O er, or Designee Date