2005-12-16_REPORT - M2001016

• Permit No: M2001016
• IBM Index Class Name: Report
• Doc Date: 12/16/2005
• Doc Name: Annual Fee/Report/Map
• From: Aggregate Industries - WCR 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:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Aggregate Industries -WCR, Iuc.
M-2001-016
Fredstrom Resource
January 7, 2006
RECEIVEp
DEC 16 ~ ~
11!'~`s'sua6111fi~ecgttglW
$688.00 (Due on or before your anniversary date)
Boulder
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator
shall submif the annual fee, a -report "and map showing the extent-of current disturbance"s fo affected-land; "-
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach rm~r revised written annnal report and annnal rennrt mT to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: .~NlikeR$fer-
Permittee Name: Aggregate Industries -WCR, Inc.
Address: 1707 Cole Blvd., Ste.100
Golden, CO 80401
Phone Number: [phone]
Fax Number:
/N
L_ U h n . ~e /~/, ~G ~// i
~`cl,~) 3s`3-~//ors-_
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Signature of Corporate Officer, Owner, or Designee
Date