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`!` <br />V <br />ANNiIAi, FF,F, and RF,PnRT RF.nIlF,RT <br />RE'CElVEO <br />PERMITTEE NAME: Lafarge West, Inc. <br />PERMiT NO.: M-2000-041 JUN T 0 ZOU3 <br />OPERATION NAME: Evans #2 Pit Division ~t Minerals and Genfogy <br />ANNIVERSARY DATE: June 21, 2003 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Pueblo <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 accotnphshed-fo date and during-the pPeceding 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 xpur revised written anneal re¢Qrt and annual rennrt m ~n fn thin form. Please note that an <br />adequate/y labeled map that c/early delineates and includes the above elements may suffice jor a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permi[tee Contact: Gary J. Tuttle <br />Permittee Name: Lafarge Wes[, Inc. <br />Address: 1590 W. 12th Ave. <br />Denver, CO 80204 <br />Phone Number: (303) 657-4123 <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 />Date <br />M:~PERM ITMASTE R DOC UM ENTSUA-AF-01 <br />