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1 "' <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />1/ <br />Arkins Park Stone Corp. <br />M-1994-080 <br />Berthoud Sunset <br />October 28, 2003 <br />RECEIVED <br />SEP 181003 <br />Division of Minerals and Geolegv <br />$281.00 (Due on or before your anniversary date) <br />Larimer <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 <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 Ymn• revised written anneal red nrt and anneal rennrf maT to this form. Please note fhat an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: t ~ ~ ~ <br />Permittee Contact: 3eei~aitl~ °d-~'-r~~ p `l Ctit2 9 <br />Permittee Name: Arkins Park Stone Corp. ~ V ~" ~/~}i~2, <br />Address: 5975 NCR 27 GVtA t,~lz!-rt~yu-p~- yI-' <br />.(/~ 't~~~.Q ~9-cXi>„-~R ci/t~.Q/J /p~^.JJI~1Q1~rW~J~m i <br />Loveland, CO 80538 ~ 'f' ~iY~-~ ~ <br />~.uupPo ~.o~-~~ ~C~A.~SrL ~9 <br />~sz.ol~y~ d-- ~c /remit-~'~J Ovl ~e <br />Phone Number: (970) 663-1920 <br />Fax Number: (970) 663-2315 ~ jam, 11.o(,e, , _ <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 aze enclosed. <br />a <br />~ S ~-~,.~ S u-t~-~ 4 <br />,.n a~/ 1„ V 1 ter ~~ <br />M:`PERMITUtASTERDOCUMENTSV.I-AE-01 <br />~ c}- 0. l l 2 <br />ycn `~ (° oz,-~~ a ~- <br />--~co- <br />~~ z <br /> <br />