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SEP-O7-2007 10:27AN FROiFDIV RECLAlWTION MINING t SAFETY 3038329102 <br />ANNIJAL FEE and REPORT REQUEST <br />PERNITIZ`EE NAME: Atkins Park Stone Corp. <br />T-412 P.002/002 F-266 <br />PERMIT NO.: M-1985-Z12 <br />OPERATION NAME: Atkins Park Quarries <br />ANNIVERSARY DATE: September 5, 2007 <br />ANNUAL FEE DUE: SS791.00 (Duc on or before your anniversary date) <br />COUNTY: I.arimer <br />RECENED <br />SEP 10 2007 <br />Divlslan of Roclamayon, <br />Mining and Safety <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-t 16, 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 the 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 your revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met unfit we have received the following compoaents; fee. report. and associated <br />~. If ao new distnrbances or redamation have occurred dprina the previous vest and new changes to <br />this in the Annual Renort. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may su~Cefor a written report. <br />Division records indicate the following petmittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact. Judy Sprague <br />Perminee Nattn+: 19lldns Par7c Stone Cotp. " <br />Address: 5975 NCR 27 <br />Loveland, CO 80538 <br />Phone Number: (970)663-1920 <br />Fax Number: (970) 663-2315 <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 />t apse o otpoL a Offic er, or Designee <br />Date <br />