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A~ ~r (Z~C <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Pete Lien and Sons, Inc. <br />PERMIT NO.: M-1989-010 V/ <br />OPERATION NAME: Weaver Quarry <br />ANNIVERSARY DATE: September 20, 2007 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Larimer <br />N~- <br />S~'l3 oboe ~Q~ <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 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 report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, resort, and associated <br />map. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to <br />the previous year's map are necessary, then no new map 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 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: <br />Permittee Name: <br />V~~ '(~e~ <br />Pete Lien and Sons, Inc. <br />Address: P.O. Box 440 <br />Rapid City, SD 57709-0440 <br />Phone Number: (605) 342-7224 <br />Fax Number: (605) 394-7246 <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 />S~ C~1 <br />Signature of Corporate Officer, Owner, or Designee REC~~ V~® <br />/G - c ~ SEP 19 SOW <br />Date dlYisjgfl p(~@ElflRlfltl®fl~ <br />Minjgll flR9l~;~/@Ey <br />