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<br />PlikMiTTEF. Neti'vIE:
<br />PEKIvIIT NO.:
<br />t~PERATION Nt\32£:
<br />:`,NNIVEKS.4kY' D.4'I'E:
<br />ANNIJAI. FEE DUP:
<br />COLJNCY:
<br />~:"~1I8i. ~E::irxurl.ay::~s~Ii'L~E!2tn'.st;
<br />.lake I{antfn=an & Sou, Inc
<br />nx-l~~s-~z?
<br />I{anCima.m 4'It
<br />CEI ~/
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<br />MAY 18 2003
<br />iYlsion of M~;~~® GeafoBY
<br />MAV;-~~,
<br />6 _A5
<br />Division m ,,~,. .
<br />~..eology
<br />£tiY,B.Ob tTlue on nr before your anniversary date}
<br />I.itYl.Cler
<br />A~eardirtg h~ C.K.S. 34-32,5-I t6 ur C.S?..5. 34-:r~-r .b, each ;ca% cn frr ttr~+ti.; ers:try date of the permit, an nl%ertior
<br />shall submit the aru.ual fee, z report a.ecl msp s'.towi: s cite cxir.:r: o current dio~arhancus ro affec'.ed land,
<br />y .._.
<br />rec.amanon accompLstied•ic dste an;t durtng zhe I;r<scrdin~ yeas,.rexv disturtts~tioes,tir:.t are, att~ctpated :o :;ccnr
<br />during the upcoming year, reclamatior+ that will be perforrttcti dw•ing the corning year, the dates for the beginning
<br />of active operations, and the date active operations ceased for the year, if'any.
<br />jrja~ns, attach vnetr revito+,t writtaro annnnl,~}y*rt nn,t Lnn ral_Ly~}yj,G~,CTiA~r ~,i,S.fp]:,pt, 1~jC[t,SC ilOtk tiff! ari
<br />atlerluutely labels,! r1,<rp rtrsr clearly rlellxentes eeta it+clw,tes me nfio+~e ele[renrs n::zy ;arjfce /or [r ~Uritt2n report.
<br />Division records indicate the forlowinb pernutt~ contact inforn~tior.. Please t~eri£y and ,sake any necesse,n~
<br />changes:- - ._...._.. , .. •
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<br />- Perrnittee Contact: .}!Lary Kauffrt;an .._.. _ __'__e=______,__~~„y
<br />_. ._,..
<br />Pern;itiee Name: Jake l; uffman & Soo, .Tnc --_,__.__._~____-._----_--_-_--- --_---_ --
<br />Address: 808 SCIr 4F;
<br />r
<br />Loveland, l",G 805:37
<br />Phune Number: {g70) 68?-1557 _.,.~ _ _._----.-,-~
<br />Fax Number: (970) 687-9985 _,,,,~ ~~___
<br />If y:;u have additional comments and,~or infonnztton than sleeuld be provided to ilia Ltivisiun, please t:recidc rt
<br />heIow 61' attach ii to this fornl al0:rg with your written reporr ,ard ttn}:, Annual kspo_°r'.nsrsur.~ti;sns are enclosed.
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