Laserfiche WebLink
999 <br /> RECEIVED 1?c <br /> ANNUAL FEE and REPORT REQUEST SEP 2 7 2V1 <br /> Division of Minerals and Geology <br /> PERMITTEE NAME: Holnam, Inc.- Ft Collins Plant <br /> PERMIT NO.: M-1977-346 <br /> OPERATION NAME: Boettcher Gypsum Quarry <br /> ANNIVERSARY DATE: October 10,2001 <br /> ANNUAL FEE DUE: $688.00(Due on or before your anniversary date) <br /> COUNTY: Larimer <br /> According to C.R.S. 34-32.5-1 16 or C.R.S. 34-32-1 16, 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 attach your revised written annual report and annual report map to this form. Please note that an <br /> adequately labeled?nap that clearly delineates and includes the 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 B.Toelle Britney L. Guggisberct <br /> Permittee Name: Holnam, Inc. - Ft Collins Plant <br /> Address: P.O. Box 1548 <br /> LaPorte, CO 80535 <br /> Phone Number: (970) 482-4065 <br /> Fax Number: (970)482-1872 <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 Af CArborate O icer or Owner <br /> q -2-L - ol <br /> Date <br /> M%PERM rMM ASTERDOCUMENTS\M-AF-01 <br />