2011-04-29_REPORT - M2009082

• Permit No: M2009082
• IBM Index Class Name: REPORT
• Doc Date: 4/29/2011
• Doc Name: Annual Fee/Report/Map
• From: Lafarge West, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Email Name: PSH
• Media Type: D
• Archive: No

Q__?
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE'ari RE
PORT REQUEST
I` /Lafarge West, Inc.
V M-2009-082
Parsons Mine
April 20, 2011
'P5h oA-
RecelVED
,?;. .
APP 29
2?,1
_j ©ivision of Rec/s?tiatltirt.
`r O mining & Safety
$$791.00 (Due on or before your anniversary date)
Weld
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
"- shall submit-the annual--fee, a-report _and map-showing- the extent of current disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anficipated to' ozzifr- - - --
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report may to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
map. If no new disturbances or reclamation have occurred during the previous year and no new changes to
the previous year's map are necessary, then no new map is required, provided that the Operator shall state
this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the
above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Todd Ohlheiser
Zo6VE F - O , T?41
Permittee Name:
Address
Phone Number:
Fax Number:
Lafarge West, Inc.
10170 Church Range Way, Suite 200
Westminster, CO 80021
[phone]
[phone]
0?3 &!9;1 - 4°3:;?
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
C-
Signature of Corporat er, Owner, or Designee
Date