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-~a <br />PERMITTEE NAME: Lawrence Construction Company ~"~~ <br />. <br />PERMIT NO.: M-1974-041 ~~ `v <br />OPERATION NAME: Lawrence Pit FEB p y ?170y <br />ANNIVERSARY DATE: January 29, 2004 9ins»n°{fn~n <br /> ?r,l;,r.; „~~~, <br />ANNUAL FEE DUE: $688.00 (Due on or before your anni versary date) <br />COUNTY: Douglas <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-accomplished to-date-and-during the-preeeding-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 y~rr revised written anneal rennrt and anneal rennrt main to this form. Please note that an <br />adequately labeled map that clearly 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: Bill Lawrence <br />Permittee Name: Lawrence Construction Company <br />Address: 9002 N. Moore Rd. <br />Littleton, CO 80125 <br />Phone Number: (303) 791-5642 <br />Fax Number: (303) 791-5647 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it ~o j~iis form along with your written report and map. Annual Report instructions are enclosed. <br />Signature df Corpo#afe Officer, Owner, or Designee <br />a -~v-v~ <br />Date <br />M iPERM ITVNASTER DOCUMENTS~hi-AF-01 <br />