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~~ ~ ~T <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Pete Lien and Sons, Inc. <br />PERMIT NO.: M-1977-302 / <br />~~- <br />S£P t ~ ~~ >/ <br />OPERATION NAME: Owl Canyon Quarry '~ ~ . . <br />ANNNERSARY DATE: September 24, 2007 V <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Larimer <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 vour 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 urevious vear and no new chances to <br />the previous year's man are necessary, then no new mao 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: Mitch Nachtigall <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 ~b05~ ~'TZ-124 <br />Fax Number: ~b~~) ~ IT ~~,~}~j <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 />~(~~ <br />Signature of Corporate Officer, Owner, or Designee <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />/~-/o~~~ <br />Date <br />RECEIVED <br />SEP T3 2001 <br />Dlvlaian of Realama0on, <br />Mining and Safety <br />