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r <br />AF <br />ANNUAL FEE and RE ORT REQUEST <br />PERMITTEE NAME: A? Loukonen Bros. Stone Company <br />PERMIT NO.: V11-2001-114 <br />OPERATION NAME: Starks Quarry <br />ANNIVERSARY DATE: August 26, 2009 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Larimer <br /> <br />AUG z 2009 <br />')'vision of Reclamation, <br />Mining and Safety <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-accomplisl3ed-to-date-and=dufing=the?preceding-year;-new-disturbances-that-are-anticipa <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 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 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 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: 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 <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />&- t-7-o9 <br />Date