2008-04-18_REPORT - M2000034 (6)

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ANNUAL FEE and REPORT REQUEST PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: Lafarge West, Inc. M-2000-034 Loveland Pit Apri130, 2008 $$791.00 (Due on or before your anniversary date) Larimer 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 current 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 for the year, if any. Please attach your revised written annual report and annual reuort man to this form The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated man. If no new disturbances or reclamation have occurred durinE the previous vear and no new changes to the previous year's map are necessary, then no new map is required, provided that the Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Robert O. Ray Permittee Name: Lafarge West, Inc. Address: 10170 Church Ranch Way, Ste. 200 Westminster, CO 80021 Phone Number: (303) 657-4579 Fax Number: (303) 657-4037 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 Offi ,Owner, or Designee ~ ~~g ~~ Date