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�' • III IIIIIIIIIIIIIIII <br /> • 999 <br /> ANNUAL FEE and REPORT REQUEST <br /> PERMITTEE NAME: Southwestern Portland Cement RECEIVED <br /> PERMIT NO.: M-1993-041 <br /> sEP 2 2e0t <br /> OPERATION NAME: Dowe Flats Mine <br /> ANNIVERSARY DATE: September 8, 2001 division of Minerals and Geology <br /> ANNUAL FEE DUE: $688.00(Due on or before your anniversary date) <br /> COUNTY: Boulder <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 your revised written annual report and annual report map to this form. Please note that air <br /> adequately labeled nap 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: John Lohr <br /> Permittee Name: Southwestem Portland Cement <br /> Address: P.O. Box 529 <br /> Lyons,CO 80540 <br /> Phone Number: (303) 823-2109 <br /> Fax Number: (303) 823-2199 <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 /> gS gnat re of Co orate Officer or Owner <br /> Dat <br /> M:1PER Mn6NA STER DOCUMENTSN7-AF-01 <br />