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V ~.. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Lafarge West, Inc. <br />M-1974-070 <br />Nelson Pit <br />February 15, 2006 <br />$688.00 (Due on or before your anniversary date) <br />Weld <br />RECEIVED <br />FEB , ~ 2006 <br />Dmsion of Minerals antl Geology <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 ymn• revised written annual red nrt and anneal reQnrt main in 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: Eric Reckenfine <br />Permittee Name: Lafage West, Inc. <br />Address: 10170 Church Ranch Way, Suite 200 <br />Westminster, CO 80021 <br />Phone Number: (303)657-4330JO~-(p~~-~}C~O <br />Fax Number: (303) 657-4339 ~~~~ (c~S7- ~(7~~ <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 />(°.u P ~ 12op ~ a v l~i~ut 4 l~ <br />Signature of Corporate Officer, Owner, or Designee <br />~1~31c~ <br />Date <br />