2006-09-27_REPORT - M1991081 - Laserfiche WebLink

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Li~~ PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNNERSARY DATE: ANNUAL FEE DUE: COUNTY: ~ ANNUAL FEE and REPORT REQUEST Charles Bud Keeling / M-1991-081 Keeling Pit September 23, 2006 ;v~~1~-- io-i~~ RE~E~~ED .~ SFF ~ ~ 7og6 division of Reoiemation Mining and Safety ' $281.00 (Due on or before your anniversary date) Huerfano 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 tt~c-annual fee, a report and map showi.7g tree extent of current d,sturbanecs- to -affected iand- 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 map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated mam (All 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 su :ce or pp written report. // / ~ ~9~ is r 6~ [Qrnq is d-f, ~~ '~p Srrx ctS ~~o w./ O~ aS Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Sam M. Keeling Jr Permittee Name: Charles Bud Keeling Address: P.O. Box 361 LaVeta, CO 81055 Phone Number: Fax Number: (719)742-5557 If you have additional comments and/or information that she below or attach it to this form along with your written report an Signature of Corporate Officer, O r, or Designee y-~~ - ~~t Date ~~~t~ u~~ u~2~1 ~~c~k.~ ,.~ „ it