2007-09-07_REPORT - M2003052 - Laserfiche WebLink

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r PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: ANNUAL FEE and REPORT REQUEST Carder, Inc. M-2003-052 Windy Ridge Pit September 2, 2007 ~C~~~p ~®aan, tJ $$791.00 (Due on or before your anniversary date) Prowers 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 to_dale and_during the. preceding y_ear„ne~ac_disturbances.,that are_anticipatedao-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 durinc the previous year and no new chances to the previous year's map are necessary, then no new map is required, provided that the Operator shall state this in the Aunpal Report. PZease note that an adequately labeled map that clearly delineates and includes the above elements may since for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Ron Peterson Permittee Name: Address: Phone Number: Fax Number: Carder, Inc. P.O. Box 732 Lamar, CO 81052 (719) 336-3479 (719}336-0196 If you have additional comments and/or information that should be below or attach it to this form alon with your written report and map. Signature of rporate O facer, Owner, or Designee ~~~ ~~ Date provided to the Division, please provide it Annual Report instructions are enclosed.