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~-~~ RPM <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Hankins Stone Co., Inc. <br />M-2000-154 <br />Hankins Stone Quarry #1 <br />August 20, 200'7 <br />$688.00 (Due on or before your anniversary date) <br />San Miguel <br />I~n~ <br />OZ`S G~r7 /~~O <br />nyd qec~ Qp> <br />nasde/yery0q <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 the preceding year, new-disturbances that are anticipated to occur I <br />during the upcoming year, reclamation that will be performed during the coming year, the dates far the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual resort map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map (All are required regardless of the level of disturbance or absence of disturbance during the previous <br />year). Please note that an adequately labeled map that clearly delineates and includes the above elements may <br />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: Steve Hankins <br />Permittee Name: Hankins Stone Co., Inc. <br />Address: P.O. Box 164 <br />Dove Creek, CO 81324 <br />Phone Number: (970) 677-2830 <br />Fax Number: (970) 677-2830 <br />70 - <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 />f <br />/ ~ -- ~~e,r1i i-Li.ac,~Ci h S <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />