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~~ ~- ~ ~' L <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNiJAL FEE DUE: <br />COUNTY: <br />O & A Stone LLC <br />M-1994-121 <br />Vasquez Quarry No 2 <br />Apri113, 2008 <br />$$323.00 (Due on or before your anniversary date) <br />Boulder <br />~~~~0~~~ <br />APR 14 2000 <br />Division of Reciamation, <br />Mining and Safety <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-distur_bance.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 />map. If no new disturbances or reclamation have occurred during the previous year and no new chances 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: Arturo & Beth Vasquez <br />Permittee Name: O & A Stone LLC <br />Address: P.O. Box 2526 <br />Longmont, CO 80501 <br />Phone Number: (303) 775-0201 <br />Fax Number: <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 />~~~ U~~ <br />Signature of Corporate`Officer, Owner, or Designee <br />//D~©~ <br />Date <br />