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~ ~ B~~ <br />ANNUAL FEE and P RT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />/Arkins Park Stone Corp. <br />~M-1981-057 <br />Sprague Red Lyons <br />June 10, 2007 <br />R~CE~~E p <br />~~JUN 1 ¢ 2007 <br />ision of R <br />Mining and ~ Y'`~on. <br />$$688.00 (Due on or before your anniversary date) <br />Boulder <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <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 renort 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 />maa. If no new disturbances or reclamation have occurred during the urevious vear and no new chances to <br />the previous year's map are necessary, then no new maa is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may su~cefor a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Judy Sprague <br />Permittee Name: Arkins Park Stone Corp. <br />Address: 5975 NCR 27 <br />Loveland, CO 80538 <br />Phone Number: (970) 663-1920 <br />Fax Number: (970) 633-2315 <br />If you have additional comments and/or information that should be <br />below or attach it to this farm along with your written report and map. <br />Si a e of C orate Officer, Owner, or Designee <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />~~ - ~°~ <br />Date <br />