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JUN. 21. 2005 8:01AM UNITED COMPANIES N0. 854 P. 5 <br />P1;RNIT1'TEE NAME: Oldcastle SR' Gronp, Inc. dba United Companies o£ Mesa County <br />P1.RNIlT NO.: M-2001-100 <br />OPERATION NAME: BT.M Pit No. l <br />ANNIVERSARY DATE; May 15, 2005 <br />ANNUAL FEE DUE: $688.00 (Doe on or before yoar anniversary date) <br />COUNTY: Mesa <br />According to C.R.5.34-325-116 or C.RS. 34-32-116, each year, on the amaiversary date of the pemtit, as 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 preceding year, new distuubaaces that are anticipated to occur <br />during the upcoming year, reclawation 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 nay. <br />Ptease attAgh 3+nnr revised `vrtten nnnnnl rw~nnrt an nnnal re~Q~ my~,F to this form- please note that an <br />adequately labeled map that clearly delineates and includes the above elements may s~cefor a written report <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Brem'lrir. Kerr <br />Permittee Name: Oldcastle SW Q,roup, loc. dba United Companies of Mesa County <br />Address: P.O. Box 3609 <br />2273 River Rd. <br />Grand Junction, CO 81502 <br />Phone Number: (Y/O) 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 enclosed <br />Signature of Corporate Officer, Owner, or Designee <br />~_ <br />`tea,,. ;6~ a~ ~'. <br />Date <br />