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0~ <br /> <br />PERMITTEE NAME: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />PERMIT NO.: M-1977-132 <br />OPERATION NAME: Berry Pit _ _ <br />ANNIVERSARY DATE: January 16, 2004 ~~~'~~~~® <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) Jgld 9 5 2004 <br />COUNTY: Rio Blanco ~ <br />Division of Minerals and Geology <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-accomplished-to-date-and-during-the-preending-year,-new-dismrbances-that-ace-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 Ynur revised written annual rennrt and anneal rennrt m}tp to this fnrm_ Please note that an <br />adequately labeled map that clearly delineates and includes the 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: -#ickar~JeAnsen-~ <br />Permittee Name: <br />Address: <br />Oldcastle SW <br />P. O. Box 3609 <br />~JJS,.e~,-~~ I~l~rr" <br />Group, Inc. dba United Companies of Mesa County <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4900 <br />Fax Number: 9 °7 D -a43 - 59 `1~b~ <br />J - 2I6' <br />~o~ V4 <br />C-mA~~ = 6re..i:~,cerr(2~u.~~~e~-g;,com <br />0 <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 are enclosed. <br /> <br />Signature of Corporate Officer, Owner, or esignee <br />Da <br />MdPERM ITVvIASTERDOCUM ENTSVN-AF-01 <br />