2006-08-11_REPORT - M1977439 - Laserfiche WebLink

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~sc~ ~- ANNUAL FEE and REPORT REQUEST PERMTI'TEE NAME: / Lafarge West, Inc. PERMIT NO.: ~ M-1977-439 OPERATION NAME: Home Office Mine ANNIVERSARY DATE: August 15, 2006 ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) COUNTY: Lorimer ~EGEIVED AUG 112006 ~pinfsion of Reclamation, Mining 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 shall submit"the annual fee; a`report'and--map showing the extent of current .disturbances to affected ]and, 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 mau to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated map (All are required regardless of the level of disturbance or absence of disturbance during the previous year). Please note that an adequately labeled map that clearly delineates and includes 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: Mark A. Vigil Permittee Name: Lafarge West, Inc. Address: 10170 Church Ranch Way, Suite 200 Westminster, CO 80021 Phone Number: (303) 657-4123 c3~J-' ~G~ j-]_"~~ _ / !/ Fax Number: (303) 657-4037 If you have additional comments and/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. Cu,c'~ Q.~~~ Q~~ ~ ~~ ~- Signature of Corporate Officer, Owner, or Designee Date ~-'-~~