REP46872

• Permit No: M1981088
• IBM Index Class Name: Report
• Doc Date: 12/3/2003
• Doc Name: Annual Fee/Report Notice
• From: Lafarge West Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:

Lafarge West, Inc.
M-1981-088
McCoy Aggregates
November 15, 2003
RC °~ ~Y e9 i~
DEC p ;~ 2f103
Oivisian o/Minerals and Gealon,
$688.00 (Due on or before your anniversary date)
Routt
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. land, _ . _
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 your revised written annnal rennrt and anm~al rennrt m ~n to this form- 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: Eric Reckentine
Permittee Name: Lafarge West, Inc.
Address: 1400 W. 64th Ave.
Denver, CO 80221
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach i[ to this form along with your written report and map. Annual Report instructions are enclosed.
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Signature of Corporate Officer, Owner, or Designee
.J.~c ~_ 2003
Date
MiPERM ITVNASTERDOCUM ENTSVN-AF-01