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°JrV''~ <br />~~Z <br />~i ~~ ~-~~ <br />PERMITTEE NAME: ~ Lafarge West, Inc. RECEIVED <br />PERMIT NO.: >/ M-2000-113 / N~~ n 4 inns <br />OPERATION NAME: ~ Mamm Creek Sand & Gravel Division of Reclamation <br /> , <br />Mining and Saf <br />t <br />ANNIVERSARY DATE: October 29, 2006 e <br />y <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Garfield <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 disturbarsces'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 resort maa 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 vear and no new chanties to <br />the nrevious year's man are necessary. then no new moo 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 since jor a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Mark A. Vigil <br />Permittee Name: Lafarge West, Inc. <br />Address: 10170 Church Ranch Way, Suite 200 <br />Westminster, CO 80021 <br />Phone Number: (303) 657-4123 30?r- (257-1-1 GYx7 <br />Fax Number: (303) 657-4037 <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 />S(i~gnat_ure of Corporate Officer, Owner, or Designee <br />I ~J~(n.~>1 7y ~XXr, <br />Date <br />