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~~ - ~ IL <br />PERMITTEE NAME: Killiou Supply RECEIVED <br />PERMIT NO.: M-1985-184 MAR 0 5 2004 <br />OPERATION NAME: Killion Supply <br />Division of Minerals & GeoloBY <br />ANNIVERSARY DATE: February 18, 2004 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COIJN"TY: Larimer <br />- ~^^ord;ng r~ (' R C ~4,32„~1,16 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 istur-bances Lo affecte8'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 ynnr revised written annual report and annual report main to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the 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: Jamie Killion <br />Permittee Name: Killian Supply <br />Address: 862 W. Willox Ln. <br />Fort Collins, CO 80524 <br />Phone Number: (970) 482-0358. _ <br />Fax Number: (970) 221-1626 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />owner, or Leslgnee <br />M:~PERMInMASTERDOCUMENTSVN-AF-01 <br />~/~~ <br />