2004-09-20_REPORT - M1994080

• Permit No: M1994080
• IBM Index Class Name: Report
• Doc Date: 9/20/2004
• Doc Name: Annual Fee/Report/Map
• From: Arkins Park Stone Corp.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

i
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNCY:
Arkins Park Stone Corp.
M-1994-080
Berthoud Sunset
October 28, 2004
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SEP 2 0 2004
Division of Minerals & Geology
$281.00 (Due on or before your anniversary date)
Larimer
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
shall submit the annual fee, a report and map showing the extent of cun•ent disturbances to affected land,
-reclamation accomplished lo. date-and during ~he preceding-year,-new-dishirbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach yonr revised written anm.al report and annnal repo m to this form- Please note that an
adequately labeled map [hai clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: "----nrc..-C-im3cvr-
Permittee Name: Arkins Park Stone Corp.
Address: 5975 NCR 27
Loveland, CO 80538
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annua] Report instructions are enclosed.
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