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~~ <br />~~ ~ R~ <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Pete Lien and Sons, Inc. ~y- <br />PERMIT NO.: M-1977-304 ,~~ <br />OPERATION NAME: Rex Quarry -Sec 36 sFQ , <br />ANNNERSARY DATE: September 26, 2007 c. `3 ~7 / <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, rec?area±ion-that-wiil be-per-fortaed-during the-coming-year, the-dates-for the beginning- <br />ofactive 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, report, and associated <br />mau. If no new disturbances or reclamation have occurred during the arevious veer and no new chanties to <br />the previous year's map are necessary, then no new map is required, provided that the Ouerator 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 pennittee 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 ~605~ ~9'Z.'~ZZ,q' <br />Fax Number: (6h5) 394 `346 <br />If you have additional comments and/or information that should be <br />below or attach it tot ' form along with your written report and map. <br />Signature of orporate Officer, Owner, or Designee <br /> <br />Date <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />RECEIVED <br />SEP 1~3 2001 <br />Dlvlslan of ReGamalion, <br />Mining sqd Safety <br />