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<br /> <br />~I <br />PERMTTTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />M-2002-114 <br />15 Road Pit <br />March 13, 2004 <br />$688.00 (Due on or before your anniversary date <br />IYlilda ai Minerals & Oealogy <br />Mesa <br />RECEIVED <br />MAR 2 9 2004 <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator - - ' <br />- - shall submit-the-annual-fee, _a_report_and_map_showing_tlte_extent of_current disturbances to affected land, _ <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur I <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written annnal report and annual re~nrf main to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: ~ 1 <br />PermitteeContact: ~ete$iegrefenfd~ ~~it¢~,.,,~ ~~ /leY~ <br />Permittee Name: Oldcastle SW Group, Inc. dba United Companies of Mesa County <br />Address: 2273 River Rd. <br />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 enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />