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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Lafarge West, Inc. <br />M-1974-015 <br />Lyons Pit <br />February 15,2006 <br />$688.00 (Due on or before your anniversary date) <br />Boulder <br />REC~IVCD <br />FEB 1 ~ 2006 <br />Dwision of Minerals and Geology <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-fhe annual-fee,a report and map showing the extent of current dfsturbances to affec ed-tand, <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 ~r revised written annual report and anneal report m„n 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: <br />Permittee Contact: Eric Reckentine <br />Permittee Name: Lafarge West, Inc. <br />Address: 10170 Church Ranch Way, Suite 200 <br />Westminster, CO 80021 <br />Phone Number:.. (303) 657-4330 ~~ -~D57- ~L~C~ <br />Fax Number: ~JC73-(nS7 ~O?~`7 <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 Designee <br />Z'~~/ ~~2 <br />Date <br />