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999 <br /> ANNUAL FEE and REPORT REOUEST ECEI VED <br /> PERMITTEE NAME: Arkins Park Stone Corporation MAY 0 12001 <br /> PERMIT NO.: M-1985-211 Divisi�n of Minerals and Geology <br /> OPERATION NAME: Berthoud Pink Quarry <br /> ANNIVERSARY DATE: April 29,2001 <br /> ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br /> COUNTY: Larimer <br /> According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary do a of the permit, an <br /> operator shall submit the annual fee, a report and map showing the extent of current dist rbances to affected <br /> land, reclamation accomplished to date and during the preceding year, new disturbances t tare anticipated to <br /> occur during the upcoming year, reclamation that will be performed during the coming ye r, the dates for the <br /> beginning 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. Please note that an <br /> adequately laheled map that clearly delineates and includes the ahove elements may s fce for a written <br /> report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Tanya Geiser <br /> Permittee Name: Atkins Park Stone Corporation <br /> Address: 5975 NCR 27 <br /> Loveland, CO 80538 <br /> Phone Number: (970)663-1920 <br /> Fax Number: 0 <br /> If you have additional comments and/or information that should be provided to the Divisi , please provide it <br /> below or attach it to this form along with your written report and map. Annual Rep rt instructions are <br /> enclosed. <br /> Signature Corporate Officer oVOwner Q <br /> � 3Uo/ <br /> Date <br /> 3a- Sli <br /> MAPERM ITWASTERDOCUMENTSN-AF-0I `t �/ <br /> f ' ,i <br />