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<br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Aggregate Industries -WCR, Inc. REiCE~VED <br />PERMIT NO.: M•1994-027 DEC 0 9 1001 <br />OPERATION NAME: Longmont Operation Division of Minerals and Geology <br />ANNNERSARY DATE: December 31, 2002 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: 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 [he annual fee, a report and map showing the extent of current disturbances to affected land, <br />recfamation accomplished to date and during the preceding year, new disturbances that are aniic'tpated 20 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 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 -WCR, Inc. <br />Address: 3605 S. Teller St. <br />Phone Number: <br />-Fax Number: <br />Lakewood, CO 80235 <br />(303)985-]070 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach i[ [o this form along with your written report and map. Annual Report instructions are enclosed. <br />1~ <br />Signature of Corporate Officer, Owner, or Designee <br />as Nod oa <br />Date <br />M:~PERMmMASTERD000MENTSNr-AF-01 <br />