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~~ F ~' ,~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />I/.~And K Limestone Products, LLC. <br />-2000-116 <br />J and K Limestoue Products-Villa Grove Pit <br />January 24, 2007 <br />~~ ANt~g1007 <br />Inln9~ntl~~ ~~~®H, <br />$$688.00 (Due on or before your anniversary date) <br />Saguache <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, 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~nd-daring-the-preceding-year, new-disturbances-that-are-anticipated-to-occur-- - <br />during the upcoming yeaz, 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 upon revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new chances to <br />the previous year's map are necessary. then no new map is required. provided that the Operator shall state <br />this in the Auuual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Jim Willschau <br />Permittee Name: J And K Limestone Products, LLC. <br />Address: 1410 CR 2 E. <br />Phone Number: <br />Fax Number: <br />Monte Vista, CO 81144 <br />(719)852-2760 <br />(719)852-2685 <br />If you have additional comments and/or information that should be <br />below or attach it to this form along with your written report and map. <br />Sign tore of orporate Officer, Owner, or Designee <br />-~7 -~7 <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />Date <br />