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i <br />~.. <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />,fir = K,~,i- <br />Pete Lien and Sons, Inc. <br />'~M-1989-010 <br />Weaver Quarry <br />September 20, 2005 <br />~rL/ <br />~1* . <br />- J~~ Q 9 Cui',~ <br /> <br />$688.00 (Due on or before your anniversary date) <br />Larimer <br />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 <br />_ _ _shall_submit the_annual_fee,.a-report-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 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 anmial rennrt and anm~al rennrt m ~n to this fnrm_ Please note that an <br />adequately dabeded 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: Lecia Craft <br />Permittee Name: Pete Lien and Sons, Inc. <br />Address: P.O. Box 767 <br />Rapid City, SD 57709-0440 <br />Sheti1~ Er~cKgon <br />F.O. E~OX 440 <br />Shone-Number:____(60S).342-2224 _ - _ __ ___ . . _ - -- _ _ _ . _- <br />Fax Number: (60S) 394-7246 <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 />Signature of C rporate Officer, Owner, or Designee <br />Date <br />