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~~-i <br />~,~~ <br />~ANNi1Ai. FF.F, and RF.Pf1RT RF.CIiTFST <br />PERMITTEE NAME: i/ L <br />afarge West, Ine. RECEIVED <br /> / <br />PERMIT NO.: I/IVI-1997-087 <br />~UN 3 ~ ~~~ <br />OPERATION NAME: Hartman Pit w <br />ANNIVERSARY DATE: June 15, 2006 `'u~Y~sion of Minerals and Geology <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Pueblo <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 ]and, <br />reclamatiomaccomplished 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'~nnr revised written anm.al re~nrt and anmial report man to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Mark A. Vigil <br />Permittee Name: Lafarge West, Inc. <br />Address; 10170 Church Ranch Way, Suite 200 <br />Westminster, CO 80021 <br />Phone Number: (303) 657-4123 ~~j- („Gj~]- ~~ ~' <br />Fax Number: (303)657-4339 ~~ (pCJ'T ~~~J~ <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 />(°,eac~ ~ ~ ~.o ht9 ~r~ll~ <br />Signature of Corporate Officer, Owner, or Designee <br />~laa I~x~ <br />Date <br />