REP18417

• Permit No: M2000090
• IBM Index Class Name: Report
• Doc Date: 1/9/2004
• Doc Name: Annual Fee/Report Notice
• From: Loukonen Bros. Stone
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Loukonen Bros. Stone
M-2000-090
Lykins Gulch
February 1,2004
$281.00 (Due on or before your anniversary date)
Boulder

RECEIVED
J~4N 09 2004
Division of Minerals & GeoloBY
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
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written annual re,~nrt and annual report man to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Michael Loukonen
Permittee Name: Loukonen Bros. Stone
Address: 12993 N. Foothills Hwy.
Longmont, CO 80503
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
/X~
Signature of Corporate fficer, Owner, or Designee
~A /D
Date
M:IPERMINIASTERDOCUMEMSIM-AF-01