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SEP-05-2008 06:25AM FROM-DIV RECLAMATION MINING & SAFETY +3038328106 T-403 P.003/007 F-468 <br />/ice <br />O? <br />ANNUAL FEE an REPOR REQUEST <br />PERMITTEE NAME: 'frCEMEX, Inc. -• <br />PERMIT NO.: ?fd-1977-208 b nOg <br />CEP `? 2 <br />OPERATION NAME: Lyons Quarry <br />ANNIVERSARY DATE: September 8, 2008 -.a <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Boulder <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 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 vour revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components. fee, report, and associated <br />trap. Yf no new disturbances or reclamation have occurred during the previous vear and no new changes to <br />the previous vear's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Patrick Fischer <br />Permittee Name: CEMEX, Inc. <br />Address: P.O. Box 529 <br />Lyons, CO 80540 <br />Phone Number: (303) 823-2100 <br />Fax Number: (303) 823-2199 <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 />ev? <br />'Corpor to Officer, Owner, or <br /> <br />Dato