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<br />RECEIVED <br />JUN 2 8 2002 <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 />High Plains Stone Company <br />M-1990-016 <br />South 40 Quarry <br />July 11, 2002 <br />$281.00 (Due on or before your anniversary date) <br />Fremont <br />Division of Minerals and Geology <br />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 <br />----shall-submit-ihe-annual-fee,- a-report and -map-showing-the -extent- ef- curren~disturbanees-to-a€feeted-]and; - <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 resort maa to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may 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: Scott Wagner <br />Permittee Name: High Plains Stone Company <br />Address: P.O. Box 100 <br />Castle Rock, CO 80104 <br />Phone Number: (303) 791-1862 <br />Fax Number: (303) 791-1919 <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 Report instructions are enclosed. <br />Signature of Corporate Offic or Owner <br />cam- ass -oa <br />Date <br />M:NERM(MIASTEAD000MENTSVN-AF-01 <br />