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AN AL ftE an REPORT REQUEST ?, .,. <br />PERMITTEE NAME:A gregate Industries - WCR, Inc. <br />PERMIT NO.: 1977-141 -A0 <br />OPERATION NAME: Lyons Quarry <br />ANNIVERSARY DATE: December 29, 2010 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Boulder <br />e"' k <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 />map. If no new disturbances or reclamation have occurred during the previous year 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: Connie N. Davis <br />Permittee Name: Aggregate Industries - WCR, Inc. <br />Address: 1707 Cole Blvd., Ste. 100 <br />Golden; CO 80401- <br />Phone Number: (99ft)'35'3!52'005 ?.34.3? G1'8S?/D'lD <br />Fax Number: (9W8)d=56 (3 03) 7/6 `5?& ?/Q <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 />o <br />Signature of Corporate Officer, Owner, or Designee <br />Date