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v <br />C~~1 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br /> <br />Stone Wholesale Corporation <br />997-065 <br />Brownstone Quarry <br />October 22, 2005 <br />RECEIVED <br />~CT 0 5 2005 <br />71~ Division of inine~ais and GaologY <br />$281.00 (Due on or before your anniversary date) <br />Larimer <br />According to C.R;5. 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 <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 anneal report and anneal re~,pnrt maw to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffce for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Jim Striggow <br />Permittee Name: Stone Wholesale Corporation <br />Address: 11587 N. U.S. Highway 287 <br />LaPorte, CO 80535-9708 <br />Phone Number: (970) 221-0057 <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 />