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<br />ANNUAL FEE an PORT UEST <br />PERMITTEE NAME: Val o Lamar Concrete Division <br />PERMIT NO.: `? -1981-132 <br />OPERATION NAME: Lamar West Pit <br />ANNIVERSARY DATE: November 5, 2010 <br />ANNUAL FEE DUE: $5791.00 (Due on or before your anniversary date) <br />COUNTY: Prowers <br />444 f . ?? .?; d <br />c?dha? r., r u c za z? 5-11 or C R.S. 34-32-116, each year, on the anniversary date of the permit, an <br />operator shall submit the annual fee, a report and mappsliowing Fib ex`tent-o rren d-istur-bances..to-a£factod <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning 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 <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />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: Herb K. Pearson <br />Permittee Name: Valco Lamar Concrete Division <br />Address: P.O. Box 591 <br />(Dui ?rve? <br />ye,cC' 0,s&'-e' <br />( 75,3 5- Ad-eker ki ozo3 <br />Lamar, CO 81052 C'Q d' e ?? ` y ?? 3?{ <br />Phone Number: (303) 248-3590 <br />Fax Number: (800) 332-1652 303?Z?F`5-355F( <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 <br />enc sed. <br />Signature of Corporate Officer, Owner, or Designee <br />(0-a6-200 <br />Date <br />M: \PERMITVI 4ASTERDOCUMENTSW-AF-04