2002-01-03_REPORT - M1973021

• Permit No: M1973021
• IBM Index Class Name: Report
• Doc Date: 1/3/2002
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

III IIIIIIIIIIIII III
F'ERMITTEE NAME:
PERMIT NO.:
C)PERATION NAME:
F,NNIVERSARY DATE:
P,NNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
RECEIVED
JAN 0 3 2002
Division of Minerals and Geology
Aggregate Industries -WCR, [rtc.
M-1973-021
Morrison Quarry
December 31, 2001
$688.00 (Due on or before your anniversary date)
Jefferson
P.ccording 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 curtent disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated [o 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 your revised written annual report and annual report map to this form. Please note rhnt an
adequately labeled map that clearly delineates and inclatles the above elements may sake for a H~ritten report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permiuee Contact: Patrick Ward
Permittee Name: Aggregate Industries -WCR, Inc.
Address: 3605 S. Teller St.
Lakewood, CO 80235
Phone Number: [phone]
Fax Number:
If you have additional comments andlor information that should be provided to the Division, please provide it
below or attach it to [his form along with your written report and map. Annual Report instructions are enclosed.
Silmature of CorplIorate Officer or Owner
Date
M'.~P =RMIThIASTERDOCUMENT5U7~ AF-01