2007-05-04_REPORT - M1985211

• Permit No: M1985211
• IBM Index Class Name: Report
• Doc Date: 5/4/2007
• Doc Name: Annual Fee/Report/Map
• From: Arkins Park Stone Corp.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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A AL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
~ Arkins Park Stone Corp.
e~ M-1985-211
Berthoud Pink Quarry
April 29, 2007
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$$281.00 (Due on or before your anniversary date)
Larimer
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
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation accomplished to'date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming yeaz, reclamation that will be performed during the coming yeaz, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach vour revised written annual report and annual report man to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
man. If no new disturbances or reclamation have occurred durinc the arevious vear and no new chances to
the previous year's man are necessary, then no new mau is required, provided that the Operator shall state
this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the
above elements may since for a written report.
Division records indicate the following perntittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Arlis M. Sprague
Permittee Name: Arkins Park Stone Corp.
Address: 5975 NCR 27
Loveland, CO 80538
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.
Signature of Corporate Officer, Owner, or Designee
Date