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iiiiiiiiiiiiiiuiii <br />999 <br />t <br /> <br />ANNUAL FEE and REPORT REQUEST <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />J And K Limestone Products, LLC. <br />M-2000-116 <br /> <br />DEC 2 4 2001 <br />J and K Limestone Products-Villa Grove Pit Division of Minerals and Ceoloyy <br />January 24, 2002 <br />$688.00 (Due on or before your anniversary date) <br />Saguache <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-1 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 moo to this form. Please mote that an <br />adequately labeled map that clearly delineates and includes the above elements may sake for a written report. <br />Division records indicate [he following permittee contact information. Please verify and make any necessary <br />changes: <br />Pennittee Contact: Jim Willschau <br />Permittee Name: J And K Limestone Products, LLC. <br />Address: 1410 CR 2 E. <br />Monte Vista, CO 81144 <br />Phone Number: (719) 852-2760 <br />Fax Number: (719) 852-2685 <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 />of Corporate Officer or Owner <br />/2 -iii -o <br />Date <br />M.~PERM rIV.7ASTERD000MENT5UI-AF-01 <br />