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iiiiiiiuiiiiiuiu <br />999 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Barnard Quarries <br />M-199ti-079 <br />Barnard Quarry <br />January 29, 2002 <br />~{ECEIV E~ <br />JAN 2 4 2002 <br />pivision o1 Minerals and GeotogY <br />$281.00 (Due on or before your anniversary date) <br />Boulder <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-I 16, each year, on [he 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 [o date and during the preceding year; ne~.v 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 man to this form. Please note tlrot air <br />ndequate[y labeled n:ap that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate [he following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Chester Barnard <br />Permittee Name: Barnard Quarries <br />Address: 245 Evans St. <br />P.O. Box 86 <br />Phone Number: <br />Fax Number: <br />Lyons, CO 80540 <br />(303)823-6977 <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 />~e ~%~ ~ ~~ <br />Signature of Corporate Officer or Owner <br />y i_ ~~?, <br />Date <br />M ~PERMfIV.7ASTERDOCl1AtENT5NI-AF-01 <br />