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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Aggregate Industries, Inc. <br />M-2000-087 <br />Milliken Resource <br />January 12, 2003 <br />RECElVE® <br />JAN 2 3 2003 <br />Division of Minerals and Geology <br />$688.00 (Due on or before your anniversary date) <br />Weld <br />According to C.R.S. 34-32.5-] 16 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 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 Xgnr revic d written anneal rennrt and anneal rennrt man to this form. please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice 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, Inc. <br />Address: 3605 S. Teller St. <br />Lakewood, CO 80235 <br />Phone Number: (303) 985-1070 <br />- Fax Number: _.(303)-716-5299 - _ __ _- _ _ - _ <br />If you have additional comments and/or information that should be provided to the Division, please provide i[ <br />below or attach it [o this form along with your written report and map. Annual Report instructions are enclosed. <br />;) <br />.0~J7.-n/O ~ L~ <br />Signature of Corporate Officer, Owner, or esignee- <br />~'ai~u«~, a~/ o2D43 <br />RECE~VE <br />Date <br />JAN 2 3 2003 <br />Division of Minerals and Geology <br />M:~PERM771MASTERn000MEMSVv1-AF-01 <br />