Laserfiche WebLink
ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />ocr 3 0 2ooz <br />OiYisi00 of Minerals and Geology <br />Pete Lien and Sons, Inc. dba Trans Colorado Concrete <br />M-1979-192 <br />Spotted Burro Pit <br />October 14, 2002 <br />$688.00 (Due on or before your anniversary date) <br />Fremont <br />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 permit, an operator <br />shall-submit-the annual-Pee; -a report-and--map showing the extent of carren[ disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual renort map to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Lecia Craft <br />Permittee Name: Pete Lien and Sons, Inc. dba Trans Colorado Concrete <br />Address: P.O. Box 767 <br />Rapid City, SD 57709-0440 <br />Phone Number: (605) 439 3y1-'~22~-(- <br />Fax Number: (605) 394-7246 <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 [his form along with your written report and map. Annual Report instructions are enclosed. <br />G~~ <br />Signature of Corporate Offi er, Owner, or Designee <br />(ola~loy <br />Date <br />M?PERMIT~NIASTERDOC UMENTSU7-AF-01 <br />