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?'v 4-, , ? ? 7 <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Phillips Stone Company ?1- <br />M-1981-075 <br />Phillips Stone Company <br />July 30, 2008 <br />$323.00 (Due on or before your anniversary date) <br />Boulder <br />RECEWED <br />JUL 14 2000 l-1/ <br />Division of Reclamation, <br />Mining and Safety <br />_According_to_C-R-S-.-341 32.5-116-or-C.R.S. 34-32-.1-1-6; 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 vour revised written annual report and annual report may to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's may are necessary, then no new may is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please veri d make any necessary <br />changes: <br />Permittee Contact: Robert J. Phillips <br />Permittee Name: Phillips Stone Company yw C' r I R Ey <br />Address: 7850 Ute Hwy c lad m IQ ep?L <br />Longmont, CO 80503 <br />Phone Number: (303) 823-6395 <br />Fax Number: (303) 485-2706 <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 />s <br />,I Ie <br />Signature of Co rate Officer, Ow , or Designee <br />/// ZD <br />Date