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ANNUAL FEE and REPORT REQUEST <br />Phillips Stone Company <br />M-1981-075 <br />Nolan Quarry <br />July 30, 2002 <br />JUL 2 62002 <br />PERMITI'EE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />RECEIVED <br />Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Boulder <br />According to C.R.S. 34-32.5-] 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall subrru`t [he annual fee; as ieport 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 yeaz, 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 map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the 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 />Permit[ee Contact: Robert J. Phillips <br />Permittee Name: Phillips Stone Company <br />Address: 7850 Ute Hwy. <br />Longmont, CO 80503 <br />Phone Number: (303) 823-6395 <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it [o this form along with your written report and map. Annual Report instructions are enclosed. <br />1 r <br />~~ f/P <br />Signature of Corporate fficer or caner <br />~- 0 <br />Date <br />M:~PERMITMASTERDOCUMENTSVv1-AF-OI <br />