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. ~ti~ <br />ANNTIAT. FF.F, and RF.P(lRT RF.OTTFST ~r'~~ L ~ Lw5 <br />M <br />Division of i?iinerals & L'ooloTy <br />PERMITTEE NAME: <br />PERMIT NO. <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Barnard Quarries <br />M-1996-079 <br />Barnard Quarry <br />January 29, 2005 <br />$281,00 (Due on or before your anniversary date) <br />Boulder <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 />---ieclamaHon aodompli`shed'l-o date and dunng 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 annnal report and annnal report m to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above efements 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: Chester Barnard <br />Permittee Name: Barnard Quarries <br />Address: 245 Evans St. <br />P. O. Box 86 <br />Phone Number: <br />Fax Number: <br />Lyons, CO 80540 <br />(303) 823-6977 <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 />~gnature of Corporate Officer, Owner, or Designee <br />Date <br />