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IOc_ <br />_j P <br />AN AL FETE and REPORT REQUEST RECEIVED <br />PERMITTEE NAME: 4voocam Stone LLP Md 0 6 200,q <br />PERMIT NO.: ?I-2007-050 Division of Reclamation, <br />Mining and Safety <br />OPERATION NAME: Buffalo Stone Quarry 71v <br />ANNIVERSARY DATE: March 4, 2009 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Las Animas <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 attachyour revised written annual report and annual report map 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 vear's map are necessarv, then no new man 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 suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Menty?eat*- <br />,? e X0( <br />Permittee Name: Yocam Stone LLP <br />Address: 19505 County Rd 215 <br />Pritchett, CO 81064 <br />Phone Number: (719) 643-5317 <br />Fax Number: <br /> <br />If you have additional comments and/or information that should be <br />below or attac )o this form along 'th your written report and map. <br />T <br />Signature of Corporat fficer, Owner, or Designee <br /> <br />provided to the Division, please provide it <br />Annual Report instructions are enclosed. <br />Date