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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />I <br />ANNUAL FLE and REPORT REQUEST <br />~A/ggregate Industries - WCR, Inc. <br />~I-1989-120 <br />Platte Valley Operation <br />July 16, 2007 <br />~~ <br />~~~'~~k ~, " y~ <br />,,, ~ ,. <br />-~JUL 1 ~ 2007 <br />vision oT fieCloma4ion, <br />Mining and Safoty <br />$$688.00 (Due on or before your anniversary date) <br />Weld <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 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 vour revised written annual report and annual report 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 durinti the previous vear and no new chanties to <br />the previous year's map are necessary, then no new map 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 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: Cormie Davis <br />Permittee Name: Aggregate Industries - WCR, Inc. <br />Address: 1707 Cole Blvd., Ste. 100 <br />Golden, CO 80401 <br />Phone Number: (970) 378-6856 C9~o~ 3s'3- aoos- <br />Fax Number: (970) 353-2005 (r ~Q Z 3'7 ~ " 6 d'Sy6 <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 />~- ~ ~ -O'7 <br />Date <br />