2010-07-12_REPORT - M2007050 (3)

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Y° PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: A A FEE dnd REPORT REQUEST cam Stone LLP 1I-2007-050 Buffalo Stone Quarry March 4, 2010 J? RECEIVED CI/J/UL 1 ? Z010 Division of Reclamati^ mining & safety $$323.00 (Due on or before your anniversary date) Las Animas 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 shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, reclamation aomplished_to date and during the preceding year, new disturbances that are anticipated to occur -- _ during during the upcoming year, reclamation that wiIl-be perTormed d`u'ring-the coming year,-the-dates-far-the+eginning of active operations, and the date active operations ceased for the year, if any. Please attach your revised written annual report and annual report map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated map. If no new disturbances or reclamation have occurred during the previous year and no new changes to the previous year's map are necessary, then no new map is required, provided that the Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Dale Yocam Permittee Name: Yocam Stone LLP Address: 35600 County Road 215.5 Kim, CO 81049 Phone Number: (719) 980-5107 Fax Number: If you have additional comments and/or information that should be provided to the Division, please provide it below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. yo 0 Signature of Corporate Officer, Owner, or Designee 7 - ?-i6 Date