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~,- <br /> <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~F,~~~~~ <br />ANNUAL FEE and REPORT REQUEST <br />~Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />~I-2005-021 ~t~, <br />Anderson Pit <br />February 1, 2007 <br />DEB 0 5 2001 <br />$$688.00 ue on or before our anniversar date ivision of Reclamation, <br />~ Y Y fining and Safety <br />Delta <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during.the upcoming year,-reclamation_that_will_be performed during the coming year,_the_dates for_the_ _ _--' <br />beginning of active operations, and the date active operations ceased for the yeaz, if any. <br />Please attach vour revised written annual report and annual report map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred durinc the previous year and no <br />new chances to the previous year's man are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />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: Brent Kerr <br />Permittee Name: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />Address: P.O. Box 3609 <br />Grand Junction, CO 81502 <br />Phone Number: (970) 243-4900 <br />Fax Number: (970) 243-5945 <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 <br />enclosed. <br />i~~ w . 7~~ <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />M:~PERMI7~MASTERDOCUMENTSwf-AF-04 <br />