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r~tt2z <br />n hP <br />RECEIVED <br />~~ FEB 2 8 2006 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />(/ ANNfiAi. FF,F, and REPORT RF,niTF.ST <br />~ Lafarge West, Inc. <br />M-2000-016 <br />Riverbend Operation <br />March 26, 2006 <br />!/ivisioi, of Minerals ~;,~ Geology <br />$688.00 (Due on or before your anniversary date) <br />Weld <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 />reclamation accomplisfied t-o-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~nnr revised written anneal report and anneal rennrt map to this form- Please note that 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: Eric Reckentine <br />Permittee Name: Lafarge West, Inc. <br />Address: 10170 Church Ranch Way, Suite 200 <br />Westminster, CO 80021 <br />Phone Number: (970) 407-3620 <br />Fax Number: (970) 407-3900 <br />~3~ ~S7- ~~~ ~~ <br />`~3- (ash - U X37 <br />If you have additional comments andJor 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 />~) IVLtiiKSI..VW.UlA f"L"~"7 <br />Signature of Corporate Officer, Owner, or Designee <br />~. a3 ~ ~ <br />Date <br />