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iiiiiiiiiii <br />999 <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Loukonen Bros. Stone RECEIVED <br />PERMIT NO.: M-2000-090 JAN 0 8 100b1 <br />OPERATION NAME: Lykins Gulch Division of Minerals and GeeloAY <br />ANNIVERSARY DATE: February 1, 2002 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Boulder <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-I 16, each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing [iie extent of current disturbances to affected land, <br />reclamation accomplished to date and during the proceding year, new disturbances 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 ac[ivz 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. Please note tltnt att <br />ndeyunrely Inheled tnnp thnt dearly delineates and includes the ubore elements nrny since for a n rrtten report. <br />Division records indicate the following perniittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Michael Loukonen <br />Permittee Name: Loukonen Bros. Stone <br />Address: 12993 N. Foothills Hwy. <br />Longmont CO 80503 <br />Phone Number: (303) 823-6268 <br />Fax Number. (303) 823-0843 <br />If you have additional comments and/or information that should be provided [o the Division, please provide i[ <br />below or attach it [o [his form along with your written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate Officer or Owner <br />Dale <br />M:IPERM ITV.1 ASTER DOC U M ENTS~h1-A F-U I <br />