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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />C~~ <br />A~NfNiTAi. FF,F, and REPORT RF.OiTF.ST <br />'~ "A~'ns Park Stone Corp. <br />vM-1994-080 <br />Berthoud Sunset <br />October 28, 2005 <br />/G ~,~ ~--o S' <br />~ - ~ +~fG- <br />r <br />$281.00 (Due on or before your anniversary date) <br />Larimer <br />__ According to C.R.S. 34-32.$-116 or C_R.S. 34-32-116, 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 ym~r revised written anm~al report and annnal rennrt main 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: 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) 663-2315 <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 />