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2001 10:%Hm L I Y/MI NERPL KCE:OLrv't _ <br /> NG..=[5 F.3�3 <br /> III IIIIIIIIIIIII III <br /> ANNUAL YEL and REPQAT REQUEST <br /> RECEIVED <br /> PERMn'TEE NAME: Killion Supply APR 0 4 200, <br /> PERMIT NO.: M-1985-184 <br /> OPERATION NAMB: Killion Supply Division of Minerals and Geology <br /> ANNIVERSARY DATE: February 19,2001 <br /> ANNUAL FEE DUE: $688.00(Due on or before your anniversary date) <br /> COUNTY: 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 <br /> operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br /> - land,reclamation acoomplished-to date and dury.ztho preceding.year,new disturbances that are anticipated to <br /> occur during the upcoming year, reclamation that will be performed during the coming year, the dates-for the <br /> beginning of active operations,and the date active operations ceased for the year, if any, <br /> Please attach sour revised written annual report and annual report man to this_form. Please note that an <br /> adequately labeled map that clearly delmeares and includes the above elements may suffice for a written <br /> mporr. <br /> Division records indicate the following permittee contact information. Please verify and male any necessary <br /> changes: <br /> Pemrittee Contact: Brian Killion <br /> Permittee Name: Killion Supply <br /> Address: 862 W.Willox Ln. <br /> Ft, Collins,CO 80524 <br /> Phone Number: (970)492-0358 <br /> Fax Number: (970)221-1626 <br /> If you have additional comments-and/nrinformation-that_4ould be provided to the Division, please provide it <br /> below or attach it to this form along µith your written report and map. Annual Rapdh-instruedons are <br /> enclosed. <br /> Im <br /> S' ature of Corpointe Officer or Owner <br /> ra wskealt�w�lAsrmtroctn.ffiars�lt-�rar <br /> I" n n o rid ca-b i �1� l5 Sa-ryie- Q5 k s+ (,)2A.r-. <br /> lka.nr5 . <br />