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~~ t <br />ANNTIAT. FF.F, and RF.PnRT RF. TiF.ST <br />PERMITTEE NAME: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />PERMIT NO.: M-1988-037 ~~(.~'~ V~~ <br />OPERATION NAME: United/Norwood Pit <br />JUIy 0;; p~ <br />ANNIVERSARY DATE: May 25, 2004 <br />Division o1 gl• <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) ~~ end Ceoioef <br />COUNTY: Montrose <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 />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 ym~r revised written anneal re~nrt and anneal re nr~ t ~P to this fnrm_ 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: Iiisttard-Jekwse~- <br />Permittee Name: <br />Address: <br />Oldcastle SW <br />P. O. Box 3609 <br />CJ, <br />w , l~~ t-r <br />Group, Inc. dba United <br />Grand Juncfion, CO 81502 <br />Phone Number: (970) 243-4900 <br />Fax Number: (970) 243-5945 <br />Companies of Mesa County <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 />Signature of Corporate Officer, Owner, or DesD ienee <br />Z ~ ZU iJ l-f-- <br />Date <br />