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~~ <br />• <br />;/ ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: V Leonard Loukonen <br />/ M-1986-085 <br />OPERATION NAME: Weaver Quarry <br />ANNNERSARY DATE: December 5, 2006 <br />ANNUAL FEE DUE: $$281.00 (Due on or before your anniversary date) <br />COUNTY: Latimer <br />i I -a ~~ <br />~~Y ~{~~'t_ A~`'•. ~_~ <br />" L.. i <br />/%~, .L~ ~ 1 ~ 7a~Q <br />.._,„. yy <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 your revised written annual resort and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee. report, and associated <br />man. If no new disturbances or reclamation have occurred durinti the previous year and no new chanties to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />C~ <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Michael Loukonen <br />Permittee Name: Leonard Loukonen <br />Address: 12993 N. Foothills Hwy <br />Longmont, CO 80503 <br />Phone Number: (303) 823-6268 <br />Fax Number: (303) 823-0843 <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 />Sig~of Corporate Office/1~, or Designee <br />Jl-zt-ate <br />Date <br />