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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE an REPORT VEST <br />Blue Mountain Stone <br />?I1-1981-108 <br />Beech Hill Quarries <br />August 29, 2008 <br />$$791.00 (Due on or before your anniversary date) <br />Larimer <br /> <br />r -- <br />-S EP 2 4 7008 <br />?4+9;s,cr ar ? . <br />Wi? ink wr by,?,' +Jiwc <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the a_ nniversary date of the_permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning 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 <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated may. If no new disturbances or reclamation have occurred during the previous year and no <br />new chanaes to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the 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: Abe Vasquez <br />Permittee Name: Blue Mountain Stone <br />Address: 4168 Ute Hwy <br />Longmont, CO 80503 <br />Phone Number: (303) 823-9625 <br />Fax Number: (303) 823-6888 <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 />Si a e of Corporate Officer or Owner <br />Date