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<br />fl~ ~- R~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT~R/EOUEST <br />Arkins Park Stone Corp. t/ <br />M-1994-080 c/ <br />Berthoud Sunset <br />October 28, 2007 <br />RECEi~/ED <br />OCT 2 4 2001 ~ <br />Division of Radamation. <br />Mining and Safety <br />$$323.00 (Due on or before your anniversary date) <br />Lorimer <br />- According to C:R.S. 34-32:5=1-16 orC.R.S.34 33-I-16,-each year,-on-the anniversar}date-of-the permit,-an-eperato~-- <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 mau are necessary. then no new moo 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 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 Spr gue <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 />Permittee Name: kips Pa Stone orp. <br />Address: 75 NCR 27 <br /> Loveland, CO 80538 <br />Phone Number: (970) 663-1920 <br />Fax Number: (970) 663-2315 <br />