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RECEIVED <br />JAN_2.'8 2pp3 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Aggregate Industries -WCR, Inc. <br />M-1999-021 <br />Stegner Farms <br />March 6, 2003 <br />$688.00 (Due on or before your anniversary date) <br />Larimer <br />Division of Minerals anA 9eob~r <br />shall submit the annual fee, a report and map showing [he 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 ymm revised written anneal re~nrt and anneal report main to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Patrick Ward <br />Permittee Name: Aggregate Industries -WCR, Inc. <br />Address: 3605 S. Teller St. <br />Lakewood, CO 80235 <br />Phone Number: (303) 985-1070 <br />Fax Number: <br />~~ <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 />"i 1 <br />Signature of Corp°~ate Officer, Owner, or Designee <br />t l ~-~ ~ ~3 <br />Date <br />M:IPERM ITMASTERDOCUMENTSV.I-AF-01 <br />