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~,(om <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Loukonen Bros. Stone Company <br />~M-1981-277 <br />Beech Hill Quarries <br />January 11, 2008 <br />$$791.00 (Due on or before your anniversary date) <br />Boulder <br />~~~~~Qp~ <br />~C ~ ~ ~~~~ <br />Divisian of ~eclaination, <br />fining and 1~afety <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 />- -- - --- -reelamation-aecompiished-to -date-and- during-the`preceding-year, rie~v ~distorliance`s 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, report, and associated <br />ma If no new disturbances or reclamation have occurred during the previous year and no new changes 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 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: Michael Loukonen <br />Permittee Name: Loukonen Bros. Stone Company <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 />Signature of Corporate Officer, Owner, or Designee <br />1- i 7- a7 <br />Date <br />