2007-04-26_REPORT - M1995012 - Laserfiche WebLink

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//~ ~ ANIViJ ~ FE and R~ ORT REQUEST PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: / Cecil C Powell ~M-1995-012 Powell's Gravel Pit May 12, 2007 tvsr.y.Y _~.p J`.`~ $$281.00 (Due on or before your anniversary date) Moffat 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~~rePo~t_and.lnap_showing theytent~~current_distuxbances_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 vour revised written annual report and annual report mau to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated maa. 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 man is required, provided that the Operator shall state this in the Annual Report. 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: Cecil C. Powell Permittee Name: Cecil C Powell Address: P.O. Box 23 Dinosaur, CO 81610 P ~J 7'/~J ~ t Phone Number: (970) 374-2329 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 Off er, ner r Designee l/a~/D~ Dat~