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N , O /L <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Lafarge West, Inc. <br />M-1988-042 <br />Cottonwood Pit <br />February 15, 2004 <br />FEB 1 7 2004 <br />Division of Minerals & 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 extent of-cun•ent_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 annual re~nrt and annual re nn rf my~ to this form- Please note that an <br />adequately labeled map that clearly delineates and Includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Eric Reckentine <br />Permittee Name: Lafarge West, Inc. <br />Address: 1400 W. 64th Ave. <br /> Denver, CO 80221 <br />Phone Number: (303) 657-4330 _ <br />Fax Number: (303) 657-4339 <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 />~~ ~ <br />Signature of orporate Offic er, or Designee <br />Date <br />a <br />M:~PERMITN7ASTERDOCIIMENTSUI-AF-01 <br />