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1`V -)c- ?P - <br />ANNUAL FEE and REPORT REOUEST <br />PA--, R E C IC-.° ? VE D <br />PERMITTEE NAME: Loukonen Bros. Stone Company <br />PERMIT NO.: M-2001-114 ? AUG 0 5 2008 ? <br />OPERATION NAME: Starks Quarry Division w Reclamation, <br />Mining and Safety ? <br />ANNIVERSARY DATE: August 26, 2008 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: 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 shall <br />submit the annual fee, a report and map showing the extent of current disturbances to affected land, reclamation <br />- - accomplished--to date-and-during-the-preceding year.; new disturbances-that_ar-e_anticipatecLta. a coming__._-., <br />year, reclamation that will be performed during the coming year, the dates for the beginning of active operations, and the <br />date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report map to this form. The Annual Report & Fee <br />requirement is not met until we have received the following components: fee, report, and associated map. If no <br />new disturbances or reclamation have occurred during the previous year and no new changes to the previous <br />vear's man are necessarv. then no new map is required, provided that the Operator shall state this in the Annual <br />Report. Please note that an adequately labeled map that clearly delineates and includes the above elements may <br />suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary changes: <br />Permittee Contact: Michael Loukonen <br />Permittee Name: Loukonen Bros. Stone Company <br />Address: 12993 N. Foothills Hwy <br />Longmont, CO 80503 <br />Phone Number: (303) 823-6268 <br />Fax Number: (303) 823-0843 <br />If you have additional comments and/or information that should be provided to the Division, please provide it below or <br />attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />, -, z' // I Z '/" <br />Signature of Corpo ate Officer, Owner, or Designee <br />-7/14 49 <br />Date