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iii iiiiiiiiiiiu iii <br />ANNUAL REPORT RECEIVED <br />PERMITTEE NAME: Holnam Inc - Ft Collins Plant 0C~ 1 ~~ 1999 <br />,~~nerah 3 Geob9J! <br />PERMIT NO.: M-77-345 <br />OPERATION NAME: Boettcher Sandstone Quarry <br />ANNIVERSARY DATE: October 10, 1999 <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $225.00 '®~~ <br />COUNTY: Larimer <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the perrrrit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances <br />to affected land, reclamation accomplished to date and during the preceding yeaz, ne:w <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 [he date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this <br />annual report. Please note thar cur adequately lubelec! amp tluu clearh delineates and <br />includes the nbave elenreuts nuiy suffice for a written repa~t. <br />Please type or print the current contact person's name, mailing address, and phone number in the <br />space provided: , <br />COnIaCI Name: MT('HAFT R TOELLE <br />ss; P.O. BOX 1548 <br />LaPorte, CO 80535 <br />Company: unr.Nnrn rNr <br />Phone No.: ( 970) 48.2-4065 <br />FaxNo.:( 970 ) 482-1872 <br />If there are additional comments and/or information that should be provided to [he 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 />tgnature of Corporate Officer, or Owner Date c~ <br />INSTRUCTIONS ON BACK <br />