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y <br /> <br />SSS <br />PERMITTEE NAME: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />PERMIT NO.: M-1977-020 <br />OPERATION NAME: PitNol RECEIVE® <br />ANNIVERSARY DATE: March 23, 2004 MAR 2 g 2004 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) Uicisisn of Minerals & caoioer <br />COUNTY: Delta <br />According to C.R.S. 34-32.5-I 16 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_yeaz, 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 your reviced written anm~al rennrt and annual repnr 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: y~ <br />Permittee Contact: ~- IJ re n t W ~ ~ ~e +'r' <br />Penrtittee Name: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />Address: P.O. Box 3609 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4900 <br />Fax Number: (970) 243-5945 <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 />/~.nA,,,~ W `~~ e~ <br />Signature of Corporate Officer, Owner, or Desimee <br />Date <br />