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PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />R?_' C?- R P-r <br />ANNUAL FEE and REPORT REOUESTL <br />J & K Limestone Products, LLC ? <br />M-2000-116 ? <br />J and K Limestone Products-Villa Grove Pit <br />January 24, 2009 <br />$791.00 (Due on or before your anniversary date) <br />Saguache <br />I:t4 i 14, i% <br />? <br />JAN 0 7 2009 v/ <br />Division of Reclamation, <br />Mining and Safety .01 <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-accoMlished-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 man 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 map 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 verify and make any necessary <br />changes: <br />Permittee Contact: Jim Willschau <br />Permittee Name: J & 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 /> <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 />-jet In e5- A/' <br />4Siture:of orpo ate Officer, Owner, or Designee <br />Date <br />X?u ed?