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AUC-tT-04 08:50 FAOId-to!orado Division ui tlinarals & Goo!o`y •13L3866356T T-a14 P.003/0~03p F-6i6 <br />A7V'YLtAi. FRR and REPORT B~i1F'ST <br />PERIvIITTEL NAME: Loveland Ready ~Iix Concrete, Inc. RECEI VEp <br />PERMIT NO.: MI-1974-069 AUG Z 01004 <br />OPERATION NAME: Latimer Pit <br />ANNIVERSARY BATE: July 31, 2004 tl~rision of Minerals and GeofaBY <br />ANNUAL FEE DUE: $688,00 (DUe on or before your anniversary date) <br />COUNTY: Lorimer <br />According to C.R.S. 34-32.5-11G or C.R.S, 34-32.116, each year, on the anniversary date of tlx pc-rmit, an operator <br />shall Submit the annual fee, a report and map showing the extent of current disturbances to aflected land, <br />reclamation accomp]ishtd to date and during the preceding year, new disturbances that arc anticipat.d to occtn <br />dtn-ing the upcoming year, reclamation that «^:Il be performed during the coming year, the dates for the beginning <br />of aotive operations, and the date active operations ceased for the year, if any. <br />Pleacn +Macjy,y nor r^ evi"d ygritten allTM .al r_Pnrf and anneal rr~p rt man to th+c form. Please irot¢ that an <br />adzguately labeled map that elearJy de(lneates and includes the above elemenkv mqy sr~c¢ for a writlc it report. <br />Division zecords indicate the following permitter contact information. Please verify and make an'; necessary <br />changes: <br />Permittee Contact, George S. Fancher <br />Perminee Name: Loveland Ready Mix Concrete, Inc. <br />Address: P.O. Box 299 <br />Loveland, CO 80539 <br />Phone Ntanber. (970)667-2680 <br />Fax Number: (970) 667-0036 <br />If you have additional comments and~'or information that should be provided to the Division, plca~:e provide <br />below or attach it to [his form along with your written report and map. Annual Report instructions ate v~nciosed. <br />S' of C rate Of ccr, Owner. or Designee <br />Date <br />