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PERMITTEE NAME: <br />PERMIT NO.: <br />ANNUAL FEE'and REPORT REQUEST <br />Fl Lafarge West, Inc. <br />AM-2001-051 <br />OPERATION NAME: North Taft Hill Expansion Site <br />ANNIVERSARY DATE: August 1, 2010 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Larimer <br />ecs <br />AUG 2 't* 2616 <br />?!1fY3i0n th err7Ci?art?itaKate <br />Mining and Selety <br />or-- <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 your 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 />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous vear's man are necessarv. then no new man 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: Robert Ray <br />Permittee Name: Lafarge West, Inc. <br />Address: 10170 Church Ranch Way, Ste. 200 <br />Westminster, CO 80021 <br />Phone Number: (303) 657-4579 <br />Fax Number: (303) 657-4037 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />elow or attach ' is form along with your written report and map. Annual Report instructions are enclosed. <br />Signaturp of Corporat Office Owner, or Designee <br />Date