2007-09-26_REPORT - M1999034

• Permit No: M1999034
• IBM Index Class Name: Report
• Doc Date: 9/26/2007
• Doc Name: Annual Fee/Report/Map
• From: Aggregate Industries - WCR, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME: ~ Aggregate Industries -WCR, Inc.
PERMIT NO.: / M-1999-034
OPERATION NAME: Cooley Reservoir & Fulton Wildlife Area
ANNIVERSARY DATE: September 9, 2007
ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date)
COUNTY: Adams

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-:nd Safety
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,
_ __ reclam_ation_accomplish_ed 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 far the year, if any.
Please attach your revised written annual report and annual report mau 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 durinc the previous vear and no new chances to
the previous year's map are necessary, then no new maa is required, provided that the Operator shall state
this in the Annnal 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:
Address:
Phone Number:
Fax Number:
Aggregate Industries -WCR, Inc.
1707 Cole Blvd., Ste. 100
Golden, CO 80401
[phone]
[phone]
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.
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Signature of Corporate Officer, Owner, or Designee R C
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