2007-02-15_REPORT - M1974070

• Permit No: M1974070
• IBM Index Class Name: Report
• Doc Date: 2/15/2007
• Doc Name: Annual Fee/Report/Map
• From: Lafarge West, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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A
NNUAL FEE and REPORT REQUEST

PERMITTEE NAME: /
G' Lafarge West, Inc.
PERMIT NO.: 1974-070
OPERATION NAME: Nelson Pit
ANNNERSARY DATE: February 15, 2007
ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date)
COUNTY: Weld
RECEIVED
2-F~B 1 5 2001
Uwi of ReGamaaon,
fining and Safety

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 I
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- ----I
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 your revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, resort, and associated
maD. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to
the previous year's map are necessary, then no new mau is required, arovided that the Operator shall state
this in the Annual Resort. Please note that an adequately labeled map that clearly delineates and includes the
above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Mark A. Vigil
Permittee Name: Lafage West, Inc.
Address: 10170 Church Ranch Way, Suite 200
Westminster, CO 80021
Phone Number: [phone]
Fax Number: [phone]
,303- [a5~-i{C~.~
If you have additional comments aad/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.
Signature of Corporate Officer, Owner, or Designee
Dat~