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09/28/2011 14:55 FAX U001 <br />2011 -09 -28 04:43 DRMS <br />ii, ADMINESUIATIVit INFORMATION; <br />1. Pe nit Number: <br />2. Operation Name: <br />3. gut slIggigillathnow <br />Contact Person: <br />Company Name: <br />Street: <br />City: <br />State: <br />Area Code: <br />4. $uecesaor Ouerator: <br />Contact Penton: <br />Company Name: <br />Street: <br />City: <br />State; <br />Area Code: <br />11 Tax ID No. or Social Security No,: <br />3038328106 » P 2/2 <br />-2- <br />M1986085 <br />Weaver Quarry <br />R CE VED <br />SEP 2 8 2011 <br />Division of Reclamation, <br />Mining & Safety <br />tk <br />Leonard -leeenacd V <br />Loukonen Brothers Stone <br />P,Q, 333 <br />Lyons <br />CO zip Cam: 80540 <br />303 Telephhone: -6268 <br />Michael Loukonen <br />Loukonen Bros.Ston9 Compemv <br />12993 N Foothills Hwy <br />Longmont <br />CO zip Colo: 80503 <br />303 Telephone: 823-6268 <br /> <br />5. ARR tIq Fee: 5115.00 for Hard Rock operations; S144.00 for Construction Materials operations <br />Make check payable to the Division of Reclamation, Mining and Safety <br />