2006-06-30_REPORT - M1990112

• Permit No: M1990112
• IBM Index Class Name: Report
• Doc Date: 6/30/2006
• Doc Name: Annual Fee/Report/Map
• From: Lafarge West Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

cM~
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
I~ ANNiIAT. FF.F, and RF.PfIRT RF.t7iTFCT
1/ Lafarge West, Inc.
~M-1990-112
State Pit
June 15, 2006
RECEIVED
JUN 3 0 ?pp6
~+~Vision afMmerals and CeologY
$688.00 (Due on or before your anniversary date)
Pueblo
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 ym~r revised written annnal report and annnal re nn rt main to this form- please note that an
adequately labeled map that clearly delineates and includes the above elements pray suffice for a written report.
Division records indicate the following pennittee 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: [phone]
Fax Number: [phone]

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.
~v Pop.b~ tr`:I ;tzQ ~
Signature of Corporate Officer, Owner, or Designee
Date