2004-11-24_REPORT - M1998014

• Permit No: M1998014
• IBM Index Class Name: Report
• Doc Date: 11/24/2004
• Doc Name: Annual Fee/Report/Map
• From: Lafarge West Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Lafarge West, Inc.
M-1998-014
Gypsum Ranch Pit
November 3, 2004
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$688.00 (Due on or before your anniversary date)
Eagle
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 cu_ttent 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 far the year, if any.
Please attach your revised written anneal rennrt and anmral r~nrt main 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: Steve Wood
Permittee Name: Lafarge West, Inc.
Address: P.O. Box 368
Glenwood Springs, CO 81602
Phone Number: [phone]
Fax Number: [phone]
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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