2007-07-27_REPORT - M1983132 - Laserfiche WebLink

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s AN UAL FEE and REPORT REQUEST PERMITTEE NAME: / Dewitt Excavating PERMIT NO.: ~M-1983-132 OPERATION NAME: Dewitt Excavating ANNNERSARY DATE: July 29, 2007 ~ 2~ Z ~ ~ ANNUAL FEE DUE: $$1,81:00 (Due on or bef/oreJyour ann versary date) COUNTY: Prowers ~~~~lV~D -~lGlsicnot 2?20Qt Mintogandsamation ~Y 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-disturbanees-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 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, report, and associated map. If no new disturbances or reclamation have occurred during the previous year and no new chances to the previous year's mau are necessary, then no new map is required, provided that the Ouerator shall state this in the Annnal Report. Please note that an adequately dabeled 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: Terry Dewitt Permittee Name: Dewitt Excavating Address: 7395 U.S. Hwy. 50 W. Phone Number: Fax Number: Lamar, CO 81052 (719) 336-4455 (719)336-8150 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. igna e of Corporate O caner, or esignee Date