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. - ~ ~ III IIIIIIIIIIIII III <br />ANNUAL REPORT <br />PERMITTEE NAME: Holnam Inc - Ft Collins Plant <br />PERMIT NO.: M-77-348 <br />OPERATION NAME: Boettcher Quarry <br />ANNNERSARY DATE: October 10, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $550.00 <br />COUNTY: Latimer <br />Company: <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the pernut, an <br />operator shall submit the annual fee, a report and map showing the extent of current ~9isturbances <br />to affected land, reclamation accomplished to date and during the preceding yeaz, new <br />disturbances that are anticipated to occur during the upcoming year, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, and the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to I.his <br />annual report. P[ense note rhal nn n~le~(urueh labeled map tkat clearly dellnentes unr( <br />includes the above elements nuiv suffice for a ~rrit~en report. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: <br />Contact Name: MICHAEL B. TOELLE <br />Address: P • O. BOX 1548 <br />LaPorte CO, 80535 <br />Phone No. <br />1'~1@~ <br />RECEIVED <br />OCT 12 1999 <br />Diviyon olMinerats 6 Ge0b8Y <br />HOLNAM INC. <br />970. 482-4065 <br />Fax No.: ( 970 ) 482-1872 <br />L` there are additional comments and/or information that should be provided to the Division, <br />please provide it on a separate sheet and attach it to this report form along with your map and/or <br />written report. <br />/~c~ ~ r~i ~ /1- c7~-Q~- O eel 6.~ 8 / QQ'~ <br />ignature of Corporate fficer, or Owner Date <br />INSTRUCTIONS ON BACK <br />