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ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />SEP 0 62002 <br />Division of Minerals and Geology <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Arkins Park Stone Corporation <br />M-1985-212 <br />Arkins Park Quarries <br />September 5, 2002 <br />$688.00 (Due on or before your anniversary date) <br />Larimer <br />According to C.R.S. 34-32.5-] 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, :tn operator <br />----shall-submit-the-annaal-fee,-a-r€port-and-map-show.ing_the~xtent_of_curren[_disturhances_to affected _tand,_- <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 vour revised written annual report and annual report map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: ~enye-6eiscr <br />Permittee Name: Arkins Park Stone Corporation <br />Address: 5975 NCR 27 <br />Loveland, CO 80538 <br />Phone Number: (970) 663-1920 <br />(970) 663-2315 <br />~l V Gc ~Z <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 Repor[ instructions are enclosed. <br />Date <br />M:~PERM ITVNASTERDOCUMENTSVN-AF-01 <br />