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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />J~ , <br />ANNUAL FEE and~PtORT REQUEST <br />~gregate Industries -WCR, Inc. <br />.~M-1999-021 <br />Stegner Farms <br />March 6, 2007 <br />:r7`: fi';~_^~1~~~~ <br />~fE~ 7 ~ znnl <br />,- ~ '!+~~ <br />piviaic.: _,. J <br />~ Polic,l„y .:~ <br />$$688.00 (Due on or before your anniversary date) <br />Larimer <br />According to C.R.S. 34-32.5-I 16 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 vour revised written annual report and annual reaort maa to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, reuort. and associated <br />map. If no new disturbances or reclamation have occurred durinc the arevious veer and no new chances to <br />the arevious year's map are necessary. then no new maa is reauired. arovided that the Oaerator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since jor a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Connie N. Davis <br />Permittee Name: Aggregate Industries -WCR, Inc. <br />Address: 1707 Cole Blvd., Ste. 100 <br />Golden, CO 80401 <br />Phone Number: (970) 353-2005 <br />Fax Number: (970) 378-6856 <br />If you have addifional 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 />Signature of Corporat Offic~ er, or Designee <br />a~ 3-0~ <br />Date <br />