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STATE OF COLORADO <br />DIVISION OF RECLAMATION, MINING AND SAFETY ~ ~ ~ <br />Department of Natural Resources <br />5 <br />(,I <br />( p¢ 1 <br />I <br />/ <br />\ <br />G/ <br />1313 Sherman SC, Room 215 , <br />ANNUAL FE and R EPORT REQUEST W <br />` <br />'~ <br />/ <br />Denver, Colorado 80203 I C O L O R A D O <br />DIVISION OF <br />Phone: (303) 866-3567 RECLAMATION <br />FAx: (3~~EE NAME: ~ Oldcastle SW Group, Inc. dba United Companies of M sa (?~G <br />PERMIT NO.: ~M-2002-110 ~. b` ' ~ ~- ~ ~~ ~ SAFETY <br />OPERATION NAME: 19 Road Pit ~fj(~ ~ ] ~[U] Bill Owens <br /> Governor <br />ANNIVERSARY DATE: February 25, 2007 I Iston ar R:~c!c-;nation, Russell George <br />~Plining and Sa4aty Executive Director <br />ANNUAL FEE DUE: $$281.00 (Due on or before your anniversary date) <br />Ronald W. Cottony <br />COUNTY: Mesa Division Director <br />Natural Resource Trustee <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 <br />operator shall submit the annual fee, a report and-map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual reuort moo to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous vear and no <br />new chances to the urevious year's man are necessarv,then no new moo is required, arovided that the <br />Ouerator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Brent W. Kerr <br />Permittee Name: Oldcastle SW <br />Group, Inc. dba United Companies of Mesa County <br />Address: 2273 River Rd. <br />P.O. Box 3609 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4900 <br />Fax Number: (970) 243-5945 <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 <br />enclosed. <br />~~-~}- l.t~ ~ I~,c/,hi <br />Signature of Corporate Officer, Owner, or Designee <br />~~Otu ~R,t1~ 2 ~~ L b c~ <br />Date <br />Office of Office of <br />Mined idl~~l~la~~~i~1RlJOCUMENTSM-AF-04 At[ive and Inactive Mines <br />