2005-12-22_REPORT - M1996064 (2)

Home Browse Search

PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE ANNUAL FEE DUE: COUNTY: The Denver Brick Company M-1996-064 Stevens Clay Lease December 23, 2005 $688.00 (Due on or before your anniversary date) Douglas Shp RECEIVED DEC 2 22005 Oiwsiaa of uio~ais awl sayry 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 ---s;ialt ,ubi~iitilre arum~Yf'ce; a'rep~rt-an~map showing the eft-bf current d~`siurliances to affected land, -- -- reclamation accomplished to date and during 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 ~nnr revised written anm~al re;~nrl and anneal re,Rprt~mj~n this form. Please note that an adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Albert Templeton Permittee Name: -T'-° n°°..°- ° '°v r Address: 401 Prairie Hawk Dr. Castle Rock, CO ~Oi~'4 Phone Number: (303) 688-6951 Fax Number: (303j-688'~270' ~w~ e Ur~1c,~ p,~ ~rOlt~S 30~- 6tf~r- 9&9~l If you have additional comments and/or information that should be provided to the Division, please provide below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. ~• i Signature o Corporate OfficE Owner, or Designee ~~ /ott4 /b5' Date