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<br />RECEIVEC <br />AUG 15 2003 <br />flivision ~I Minerals and Geuiaay <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COCJNTY: <br />Lafarge West, Inc. <br />M-1977-036 <br />Greeley 35th Ave Pit <br />August 15, 2003 <br />$688.00 (Due on or before your anniversary date) <br />Weld <br />According to C.R.S, 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shale submit-the-annum-fee; a`report-and-map~showing'ti3e exient of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any, <br />Please attach your revis d writt n ann gal rennrt and annual rennrt m~ to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffrce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Eric Reckentine <br />Permittee Name: Lafarge West, Inc. <br />Address: 1i~0VG~!tii?fA71rGb. <br />J4D 0 (~~~y1'1 ~~. <br />Denver, CO g~$Q,4~ ~~~j <br />-_~hone_Number:_ _(303 G57-4330 _ _ _-__ - _ _ _ <br />Fax Number: 3Q ~ - tp ~ ~ -" ¢ D ~j~"- <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />be]ow or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />ignature Corporate Officer, Owner, or Designee <br />~ l~~lo~ <br />Date <br />M:~PERMITMASTERD000MENTSIhI-AF-01 <br />