2007-10-05_REPORT - M1977347

• Permit No: M1977347
• IBM Index Class Name: Report
• Doc Date: 10/5/2007
• Doc Name: Annual Fee/Report/Map
• From: Holcim ‎(US)‎ Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Holcim (US) Inc./>~
M-1977-347 ~/
Slab Canyon Quarry
October 10, 2007

RECEIVED
OCT 0 5 2001
Division of Reclamation,
Mining and Safety
$$791.00 (Due on or before your anniversary date)
Larimer
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-exten6of--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 vour revised written annual report and annual report man to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
map. If no new disturbances or reclamation have occurred during the previous vear and no new chanties to
the previous year's map are necessary, then no new map is required, provided that the Operator shall state
this in the Anneal Report. Please note that an adequately labeled map that clearly delineates and include the
above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Gordon Benton
Permittee Name:
Address:
Holcim (iJS) Inc.
Project Manager
P.O. Box 1548
La Porte, CO 80535
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 attac it to this form along with your written report and map. Annual Report instructions are enclosed.
Signature of Corporate Officer, Owner, or Designee
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