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k it Ic- <br /> <br /> <br /> AREPORT REQUEST <br /> <br />PERMITTEE NAME: Lafarge West, Inc. C?- RECEIVED <br /> / <br />PERMIT NO.: 1/M-1990-112 <br />OPERATION NAME: State Pit t?JUN 15 2009 <br />ANNIVERSARY DATE: June 15, 2009 D ivision of Reclamation, <br />ANNUAL FEE DUE our anniversar <br />ate) <br />00 (Due on or before <br />$$791 <br />Mining and Safety <br />: y <br />y <br />. <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 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 report may 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 year and no new changes to <br />the 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 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: Robert Ray <br />Permittee Name: Lafarge West, Inc. <br />Address: 10170 Church Ranch Way, Ste. 200 <br />Westminster, CO 80021 <br />Phone Number: (303) 657-4000 <br />Fax Number: (303) 657-4037 <br />If you have additional comments and/or information that should be <br />below or attach it to this form along with your written report and map. <br />Signature of Corporate Offic O er, or Designee <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />Date