Laserfiche WebLink
~,/ <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />c <br />Joel Fennern & M R Gydesen <br />~-1987-143 <br />Gold Links Mine <br />~~ <br />r,a~ ,,.,~ anU wyratlon <br />Safah, <br />July 13, 2007 ~ ~~~ I , <br />$$223.00 (Due on or before your anniversary date) <br />Gunnison <br />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 <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 vour revised written annual report and annual report mao to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, resort, and <br />associated mao. If no new disturbances or reclamation have occurred during the previous vear and no <br />new chances to the previous year's map are necessary, then no new mao is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly4/ 7- ~f <br />delineates and includes~the abov elementsts ma~ for writ.en reQort. ~~ ~-,r ~O•t/~' <br />Division records indicate the folho fw~i permittee contact information. Please verify a make any ece cry <br />changes: ~ ~~ 'ice ~`~ ~ `° "YI~.W ~~1~ <br />1- <br />Permittee Contact: Melvin R. Gydesen <br />Permittee Name: Joel Fennern & M R Gydesen <br />Address: 5062 N. Raymond Rd. <br />Luther, MI 49656-9749 <br />oc.2.P le--- ~~ <br />-~,t . <br />ti ~ ---~. / `~-3 <br />Phone Number: (231) 797-5270 <br />Fax Number: <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 />Signature of Corporate Of er, Owner, or Designee <br />Q Od <br />Date <br />M:NERM171MASTERDOCUMEN7S/M-AF-02.DOC <br />