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<br />PBRMITTEE NAME: <br />PERMIT N©,: <br />OPERATION NAME: <br />ASJNIVERSARY DATE: <br />ANMIAL FEE DUE: <br />COUNTY: <br />r ~ ~~ l <br />AIYiYUAL FEE and.I.tEPURT REQXJEST <br />`Bad Boy Stone <br />~M-1942-108 ,~ <br />Bad Boy Stone <br />RECE11/ED <br />SAN 1 5 2008 <br />f~ivi ion ~ v~ ~~ct,iai nation, <br />~ining and Safety <br />February 3, 200$ <br />$$281.00 {Due on ur before your anniversary date} <br />Boulder <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 #o date and during the preceding yeffi, new disturbances tha# are anticipated to occur <br />during the upcoming year, reclamation that.will be.pesformed during the coming year, the dates for the begirming <br />of active operations, and the date active operations ceased for fire year, if any. <br />Please attach your revised •vt'llten annual report and unauul Tenort -mau to fhfs form.- The Annual Report <br />& Fee requirement is not met untll we have received the following components_ fee. report. and associated <br />ma , If no new disturbances or reclamation have occurred Burin the revlaus ear and no new than es to <br />t_he previous year's roan are necessarv,.then no new matt is r ~ired,.provided that the Operator shall state <br />this in the Annual Report. Please note that rtn adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the following pertnittec contact information: .Please:verify and Tooke any necessary <br />changes: <br />Permittee Contact: Pablo Vasquez <br />Permittce Name: Bad Boy Stone <br />Address: 11493 WCR 20 <br />Fort Lupton, CO 80621 <br />Phone Number: {303} 857-4544 <br />Fax Number: (303) 772-9447 <br />If you have additional comments and/or information-that should be provided tv the Div%sion, please provide it <br />below or attach it to~this form along with your written report and map. Annual Report mstntcttons are enclosed. <br />Q ~ ~o <br />Signa of Corporate ©ffic r, Owner, or Designee <br />_ -----, <br />1~~ C7 <br />Date <br />RECEIVED <br />.JAN 1 5 2008 <br />Divis~a<< ~~ ~:~.:~~inai:ion, <br />Mining and. Safety <br />k~ <br />