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%~~ 1 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />hn~ <br />~ANNIIAi. FF.F, and RF.PnRT RF,niJF,ST <br />/Aggregate Industries -WCR, Iue. <br />v M-2004-051 <br />Wattenberg Lakes <br />February 10,2006 <br />RECEIVED <br />"MAR 0 B 2006 <br />D wsion of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Weld <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-exten±-of-current-disturbances-to-affected-land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur I <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 anneal rennrt and anneal repo m to this form. Please note that an <br />adequately labeled map that dearly 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: Mikettefer <br />Permittee Name: Aggregate Industries -WCR, Inc. <br />Address: 1707 Cole Blvd., Ste. 100 <br />Golden, CO 80401 <br />Phone Number: <br />Fax Number: <br />C Ols n i ~'e /V• k~~t,Y/,~ t/~ <br />(970) 3s3- aop~s` <br />~ 907 3~~'- G~s~' <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 />t V (J <br />i~ <br />Signature of Corpo Officer, Owner, r Designee <br />2 ~ a6 <br />Date <br />