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N ~ <br />4~ <br />~~~ANNiiAi, FF.F, and RF.P(1RT RF.niTF.ST ~ `~ <br />~~C~' ~~® <br />PERMITTEE NAME: Loukonen Bros. Stone JAN 0 <br />PERMIT NO.: M-1981-277 s ~~ <br />OPERATION NAME: Beech Hill Quarries viviA10° otMineralsandGeetagY <br />ANNNERSARY DATE: January 11, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Boulder <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°atfected-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 vrnur revised written annual rennrt and anneal rennrt map to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the 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: Michael Loukonen <br />Permittee Name: Loukonen Bros. Stone <br />Address: 12993 N. Foothills Hwy. <br />Longmont, CO 80503 <br />Phone Number: (303) 823-6268 <br />Fax Number: (303) 823-0843 <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 />~~i~~- <br />Signature of Corporate Officer, Owner, or Designee <br />//S~as <br />Dat~.~ <br />