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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Pete Lien and Sons, Inc. <br />M-1978-018 <br />Sheep Draw Quarry <br />September 18, 2003 <br />$688.00 (Due on or before your anniversary date) <br />Larimer <br />RECEIVED <br />SEP 171003 <br />Oiuision •f Minerals and Geob'y <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 />shall-submit-the-annual-fee,,-a-report-and-map- showing-the--extent-of-current disturbances-to-affected land; <br />reclamation accomplished to date and during [he preceding 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 active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written anneal report and anneal rennrt m ~n to this form- Please note that on <br />adequately labeled map that clearly 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: Lecia Craft <br />Permittee Name: Pete Lien and Sons, Inc. <br />Address: P.O. Box 767 <br />Rapid City, SD 57709-0440 <br />Phone Number: lkA3?''}39^4699' /ot7S - 3 ~z - 71z'f <br />Fax Number <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 />`\N~ ~ <br />Signature of Corporate icer, Owner, or Designee <br />~1~j(f 03 <br />Dat~ <br />M1PERMITMASTERD000MENTSVN-AF-01 <br />