2006-06-21_REPORT - M1987088 - Laserfiche WebLink

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whe- (~ ANNIIAi, FF,F, and RF.PDRT RF,ni1F.ST PERMTTTEE NAME: (~ Ted R. Hubbs Family Trust / PERMIT NO.: 1/ M-1987-088 OPERATION NAME: Hubbs Pit ANNIVERSARY DATE: July 14, 2006 ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) COUNTY: La Plata REC~FI!/gyp JUN 2 1 2006 f/....._.......... Y - -According-to-C-.R:S-34 32-5-1-16 or C:R:S-34-32-116,-each year,-on the anniversary'date-of the perrrmif, an opeiator shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur during the upcoming yeaz, 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 ynnr revised written annnal report and annnal re on rt mgp to this form- The Annual Report & Fee requirement is not met until we have received the following 3 components: fge,fennr ,and assoriated mag (All 3 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: Barbara Hubbs Permittee Name: Ted R. Hubbs Family Trust Address: 7994 E. Saddleback Dr. Kingman, AZ 86401 Phone Number: Fax Number: (928)692-6208 (928)692-9715 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