Laserfiche WebLink
serer,vcp <br />ANNUAL FEE and REPORT REQUEST AUG 2 4 2001 <br />Division of Reclamauon, <br />Mining and Safety <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Weld County <br />M-2005-060 <br />Ashbaugh Gravel Pit <br />September 30, 2007 <br />$$323.00 (Due on or before your anniversary date) <br />Weld <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 />operarorsnau suomtc me annual ree~ a repon ana map snowing me ex[enT or Curren[ msturoances co arrec~ea <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 man to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred durinc the previous vear and no <br />new chances to the previous year's man are necessary, then no new man is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written report. <br />Division records indicate the following petrnittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Greg Nelson <br />Permittee Name: Weld County <br />Address: 1111 H St. <br />P.O. Box 758 <br />Greeley, CO 80632 <br />Phone Number: (970) 304-6496 <br />Fax Number: (970) 304-6497 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or a ch it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signature Corporate Officer, Owner, or Designee <br />~~ ~ lb ~ <br />Date <br />M:IPERMITMASTERD000MENTSVN-AF-04 <br />