2011-09-08_REPORT - M1977361 - Laserfiche WebLink

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PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: Permittee Contact: Patrick Fischer Permittee Name: CEMEX, Inc. Address: P.O. Box 529 Lyons, CO 80540 Phone Number: (303) 823 -2100 Fax Number: Date 'I J2/2oi1 ANNUAL FEE an CEMEX, Inc. l/M- 1977 -361 Signature of C+ rporate 0 ficer, Owner, or Designee QUEST Silica Quarry September 8, 2011 $$323.00 (Due on or before your anniversary date) Boulder rn�(G 4 Y-. vcFPOR Oiv■olon ®t Kecla tiAtnttt9 and Sze' 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_prec.eding_y_ear,_new disturbances that are ant icipated 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 report map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated map. If no new disturbances or reclamation have occurred during the previous year 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: If you have additional comments and /or information that should be provided to the Division, please provide it below or a ach it to this form along with your written report and map. Annual Report instructions are enclosed.