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i <br />~G~~t <br />ANNUAL FI{E and REPORT REQUEST <br />PERMITTEE NAME: i/Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />PERMIT NO.: ~M-1979-075 <br />r~,"'~ a <br />OPERATION NAME: Chambers Gravel Pit ~ i _ n <br />A~~i~ <br />ANNIVERSARY DATE: May 29, 2007 !~ ~;qli ,~ <br />ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date) ~`'- 1 ~ruJ <br />~::,~,` <br />COUNTY: Garfield • ^ ~:-, ; y'''n, <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 />reclamafion 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 yeaz, 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 annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to <br />the urevious year's maa are necessary, then no new man is required, provided that the Ouerator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Brent W. Kerr <br />Permittee Name: Oldcastle SW <br />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 />~. `-~~ <br />J ~5 n~-,~ i.y I ) .ohhl <br />Signature of Corporate Officer, Owner, or Desi ee <br />~~l <br />Date <br />