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REP07237
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REP07237
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Entry Properties
Last modified
8/24/2016 11:37:30 PM
Creation date
11/26/2007 11:34:26 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1977567
IBM Index Class Name
Report
Doc Date
11/7/2003
Doc Name
2003 Annual Report and Fee
From
Saguache County
To
DMG
Permit Index Doc Type
Annual Fee / Report
Media Type
D
Archive
No
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_ _~ <br /> <br />~a~~°.~~~,~ <br /> <br />ni~~isinn of .~lincra!~ ^n? ?^^''~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Saguache County <br />M-1977-567 <br />Airport Pit <br />November 25, 2003 <br />$281.00 (Due o0 or before your anniversary date) <br />Saguache <br />Aging to C:R:S-34=32:5=1'1'6 or C.R:S-34=32=1~1'6;-each-year,-on the-anniversary date of-the-permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual rennrt and annual red nrt man to this form- please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following petmittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: John T. Ungefug <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Saguache County <br />P.O. Box 476 <br />Saguache, CO 81149 <br />(719) 655-2554 <br />(719) 655-2543 <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 <br />enclosed. <br />Signa re of Corporate Officer, De gnee <br />,~ ~31 b3 <br />Date <br />M:\PERM ITU1ASTERDOC UM ENTSVN-AE-04 <br />
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