2006-08-23_REPORT - M1978221 - Laserfiche WebLink

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sss PERMITTEE NAME: PERMIT NO.: .OPERATION NAME: ANNIVERSARY DATE: v ANNUAL FEE and REPORT REQUEST ~~Lowell Klinglesmith & Lenny Klinglesmith - //, M-1978-221 K-Bar-T Pit „ _ _ . _ August 23, 2006 niter 8 ~s RECEIVED ~,4UG 2 3 2006 /Division of Redamation, ; Mining and Safety - . ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) COUNTY: Rio Blanco 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 shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, reclamation_accomplished~o_date_and_during_the preceding year, new disturbanceslhat_are_anficipated_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 your 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, reuort, and associated map (All are required regardless of the level of disturbance or absence of disturbance during the previous year). 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: Lowell Klinglesmith Permittee Name: Lo v 11 {ling esmith & Lenny Klinglesmith ~_ ~ q` ~ ~~ ~ Address: 7576 CR 13 P.O. Box 1164 Meeker, CO 81641 Phone Number: (470) 878-4858 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 form along with your written report and map. Annual Report instructions are enclosed. Signature of Corporate Officer, Owner, or Designee Date