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~s ~ <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 />Pete Lien and Sons, Inc. <br />M-1977-302 v <br />Owl Canyon Quarry <br />September 24, 2006 <br />/,~P~ <br />S P 2 22006 <br />Division of{?gc/amatipn <br />°t-~ Mining and gafety <br />$688.00 (Due on or before your anniversary date) <br />Larimer <br />According to C.R.5. 34-32.5-1 i6 or C.R.S. 34-32-I 16, 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 resort 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 (All are required regardless of the -evel of disturbance or absence of disturbance during the previous <br />year). Please note that an adequately labeled map that clearly delineates and includes the above elements may <br />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: Shelly Erickson <br />Permittee Name: Pete Lien and Sons, Inc. <br />Address: P.O. Box 440 <br />Rapid City, SD 57709-0440 <br />Phone Number: (605) 939-2693 <br />Fax Number: <br />\~ ri ~4~CJR~`\ta l\ <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 />S~ <br />Signature of o orate Officer, Owner, or Designee <br />-UL <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />Date <br />