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~~ ~ <br />l/ ANNIIAi, FF.F, and RF.PnRT RF, iIF,ST <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />t/ Killion Enterprises, LLC <br />/ M-1985-184 <br />Killion Enterprises, LLC <br />APR 0 4 2006 <br />~lYldiah of Mrt~crela end tiealo![y <br />February 18,2006 <br />$688.00 (Due on or before your anniversary date) <br /> <br />Larimer <br />G2!'S1L <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 />steal}-submit-ttn;-annual-:ee; a-report -and-map- slrowing-ihe-extent-of-cvrrert-distnrbances-to~ffected-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 ~nnr revised written annual renrnrf and annual re~lrt man~n 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 />Pemvttee Contact: Jamie Killion <br />Permittee Name: Killion Enterprises, LLC <br />Address: 862 W. Willox <br />Fort Collins, CO 80524 <br />Phone Number: (970) 482-0358 <br />Fax Number: _ ~~(~~ ~ ~ - ~ (p ~ ~p ~' <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 />~ ~D~ <br />Signature of Corporate Officer, Owner, or Designee <br />Date -T <br />