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~c r v~ ~ <br /> ~ ~ ~' <br /> dAUG 2 2 2005 <br />ANNTiAi <br />FF <br />F <br />and RF <br />PnRT RF <br />iTF <br />ST <br /> , <br />, <br />. <br />. <br />.n <br />. <br />~~ ~ ~~~ <br />PERMITTEE NAME: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />PERMIT NO.: ~GI-1979-205 <br />OPERATION NAME: Chambers Pit <br />ANNNERSARY DATE: August 15, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Garfield <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 summit-the-amiual-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 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 ~nur revised written anneal report and anneal rep~nrt man to this form. Please note [hat an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Brent Kerr <br />Permittee Name: Oldcastle SW <br />i3- w .~~~n,.> <br />Group, Inc. dba United Companies of Mesa County <br />Address: P.O. Box 3609 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4900 <br />Fax Number: <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 aze enclosed. <br />Signature of Corporate Officer, Owner, or esignee <br />,qua ~s~aoos' <br />Date <br />