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F5 V\ I N.3 L?) <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />4:j F av r <br />ANNUAL FEE and REPORT REQUEST <br />Linke Construction, Inc. <br />? M-2004-061 <br />Cottonwood Quarry <br />May 23, 2011 <br />$791.00 (Due on or before your anniversary date) <br />Grand <br />RECEIVED <br />-/ APR 20 Z u":1 <br />eh Division of Redamatlon, <br />Mining & 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 />s a su mit the annual fee a re ort and ma showin the extent t <br />u ee <br />recYaiaion-ac mp`is e?i "a`lo"a e an uiing a prece ie`arnew isances flat are an icipatR? ?,4ad?? =\ <br />- d 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 changes to <br />the previous vear's map are necessarv. 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: Richard Linke <br />Permittee Name: Linke Construction, Inc. <br />Address: P.O. Box 1006 <br />Granby, CO 80446 <br />Phone Number: (970) 887-2811 <br />Fax Number: (970) 887-0188 <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 />?? /l, <br />Date