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~~5 <br />ANNUAL FEE and REPORT REpUEST <br />PERMITTEE NAME: ~/ Lafarge West, Inc. <br />PERMIT NO.: ~M-1983-013 <br />OPERATION NAME: Latham -Burkett Pit <br />ANNNERSARY DATE: November 15, 2006 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <br />r~'~'~ <br />// ~~'~ <br />RECEIVED <br />~ Nnu ~ ~ inns <br />Division of Reclamation, <br />Mining and Safety <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 />- r ieclamaiion accomplished to date and during the preceding 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 vour revised written annual report and annual resort maa to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new chances to <br />the previous year's map are necessary, then no new man is required, provided that the Oaerator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Mark A. Vigil <br />Permittee Name: Lafarge West, Inc. <br />Address: 10170 Church Ranch Way, Suite 200 <br />Westminster, CO 80021 <br />Phone Number: (303) 657-4123 <br />Fax Number: (303) 657-4037 <br />J- ~orJ~J~CL~ <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />C~-C~ <br />Signature of Corporate Officer, Owner, or Designee <br />~~S'l1~2 Jl ~ ~J~ ~ <br />Date <br />