2011-12-01_REPORT - M2001016 - Laserfiche WebLink

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ANNUAL FEE and REPORT REQUEST PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: Aggregate Industries - WCR, Inc. M- 2001 -016 Fredstrom Resource January 7, 2012 $$791.00 (Due on or before your anniversary date) Boulder 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 preceding year, new disturbances that are anticipated 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 yea and no new cha nges to the p revious year's map are necessary, then no new map is required, provided t hat the Oper ator 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: Permittee Contact: Connie N. Davis Permittee Name: Aggregate Industries - WCR, Inc. Address: 1707 Cole Blvd., Ste. 100 Golden, CO 80401 Phone Number: (303) 985 -1070 Fax Number: (303) 716 -5340 If you have additional comments and /or information that should be provided to the Division, please provide it below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. Signature of Corporate Officer, Owner, or Designee Date