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JJob <br />ANNU &LE and REPOR REQUEST <br />PERMITTEE NAME: T I Operations LP dba Western Aggregates <br />r <br />PERMIT NO.: M-1988-108 , 1 ' t <br />OPERATION NAME: Western Aggregates Dlvls?,.;n cto?? ` "= ^'`'"' <br />ANNIVERSARY DATE: November 29, 2010 4v h.?a>>r'7 & ?? <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Jefferson <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 report and annual report map 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 durinE the previous year and no new changes to <br />the previous Year's map are necessarv, 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: Ran ulton <br />h <br />Permittee Name: TXI Operations LP dba Western Aggregates <br />Address: 11728 Hwy 93 <br />Boulder, CO 80303 <br />Phone Number: (303) 499-1010 <br />Fax Number: (303) 494-5464 <br />If you have additional comments and/or information that should be <br />below o ac it to this form along with your written report and map. <br />Signat re of Corporate fficer, Owner, or Designee <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />Date