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<br /> ANNiIAi. FF.F, and RF,PnRT RF.t liiF.ST <br />oo'' <br />~o <br />PERMITTEE NAME: Lafarge West, Inc. pv <br />Gv~~V <br />PERMIT NO.: M-1979-002 N~V 1 ~ ~ <br />dotec4 <br /> ~ <br />aa <br />OPERATION NAME: North Delta Pit lMmeeats <br /> pwlswao <br />ANNIVERSARY DATE: November 15, 2003 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Delta <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 />reclamation 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 ynnr revised written annnal rennrt and annnal rennrt m,~ fn 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: Gary J. Tuttle <br />Permittee Name: Lafarge West, Inc. <br />Address: 1590 W. 12th Ave. <br />`Gr'it ~l~C~"'f1~1~P . <br />Moo ~>~- (-+~1-4, Ate.. / <br />Denver, CO 80204 i~23~1~r CO 7~Vd~1 / <br />Phone Number: (303) 657-4123 ~ ~?\~~ /~~jr(- ~;~j,~~_~ <br />Fax Number: ~ ' (! ~~) Ip~' t ~©~~] / <br />If you have additional comments and/or information that should be <br />below or attach.it-tm~this form along with your written report and map. <br />///L <br />Signature of Corporate Officer, Owner, or Designee <br />Date r <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />M:NERMITNIASTERD000M ENTSUI-AF-01 <br />