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ANNUAL FEE and REPORT REQUEST RECE,v ED <br /> PERMITTEE NAME: Pete Lien and Sons, Inc. SE? 1 % �0�\dGeoto9V <br /> PERMIT NO.: M-1977-304 D`v,510o01Mjnelaksaa <br /> OPERATION NAME: Rex Quarry -Sec 36 <br /> ANNNERSARY DATE: September 26,2001 <br /> ANNUAL FEE DUE: $688.00(Due on or before your anniversary date) <br /> COUNTY: Larimer <br /> According to C.R.S. 34-32.5-1 16 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 report and annual report map to this form. Please note that an <br /> adequately labeled snap that clearly delineates and includes the above elements stay suffice for a written report. <br /> Division records indicate the following permittee contact information. Please verify and make any necessary <br /> changes: <br /> Permittee Contact: Lecia Craft <br /> Permittee Name: Pete Lien and Sons. Inc. <br /> Address: P.O. Box 767 <br /> Rapid City, SD 57709-0440 <br /> Phone Number: (605) 342-7224 <br /> Fax Number: <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 rm along with your written report and map. Annual Report instructions are enclosed. <br /> Si ture of Corp e Officer or Owner <br /> Date <br /> M WERNIH-04ASTERDOCUMENTSW AF01 <br />