2007-06-28_REPORT - M1986074 - Laserfiche WebLink

Home Browse Search

~-~=~~ ANNUAL FEE an REPORT REQUEST PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: ~Kym A. Schure /1~I-1986-074 Dollerschell Pit June 30, 2007 RECEIVED ~~N 2 8 2001 ~'v!51~ of Reclamation, nmg and Safety $$281.00 (Due on or before your anniversary date) Logan According to C.R.S. 34-32.5-116 or C.R.S. 34-32-i 16, each yeaz, on the anniversary date of the permit, an operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, reclamation a'ccomplishPd-to date-and-dcmtfg'the-preceding-year; new disturbances that are-anticipated-to-occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active operations, and the date active operations ceased for the year, if any. Please attach vour revised written annual report and annual report map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated map. If no new disturbances or reclamation have occurred durinti the previous vear and no new chanties to the previous year's map are necessary, then no new map is required, provided that the Operator shall state this in the Annual Report. Please note [hat an adequately labeled map that clearly delineates and includes the above elements may since for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Pennittee Contact: Kym A. Schure Permittee Name: Address: Kym A. Schure 12826 CR 37 Sterling, CO 80751 Phone Number: (970) 522-9485 Fax Number: If you have additional comments and/or information that should be provided to the Division, please provide it below or attach it to this f along with your written report and map. Annual Report instructions are enclosed. Si e of Corporate Officer, Owner, or esignee Date