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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />F f~~~i <br />ANN~AL FEE and REPORT REQUEST <br />~TXI Operations LP dba Western Aggregates <br />~-1988-108 <br />Western Aggregates <br />November 29, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Jefferson <br />~i <br />~OV 212007 <br />Div ion or ~:eciamation, <br />Mining anti Safety <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 your revised written annual resort and annual report man to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous veer and no new chances to <br />toe previous year's map are necessary, then no new map is required. provided that the Operator 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 for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Randy Moulton <br />Permittee Name <br />Address: <br />TXI Operations LP dba <br />11728 Hwy 93 <br />Boulder, CO 80303 <br />Phone Number: (303) 499-1010 <br />Fax Number: (303) 494-5464 <br />Western Aggregates <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below atta hit to this form along with your written report and map. Annual Report instructions are enclosed. <br />G/ ~~!G~~G /~~ <br />Signa a of Corporate Officer, Owner, or Designee <br />// D D ~ <br />Date <br />