Laserfiche WebLink
iiiiiim iii • <br />A,N1yiJAI~ FEE and REPORT REQUEST <br />PERMITTEENAME: Park County RECEIVED <br />PERMIT NO.: M-1980-012 MAR 2 0 2001 <br />OPERATION NAME: Valley of the Suu Plt f)iuision of Minerals and Geology <br />ANNIVERSARY DATE: April 1, 2001 <br />ANNUAL FEE: 5281.00 (Due on or before anniversary date) <br />COUNTY: Park <br />According to C.R.S. 34-32.5 or C.R.S. 34-32-I 16, each year. On the anniversary date of <br />the permit, an operator shall submit the annual fee, a report and map showing the extent <br />of cwrent distwbances to affected land, reclamation accomplished to date and during the <br />preceding year, new disturbances that one anticipated to occw during the upcoming year, <br />the dates for the beginning of active operations, and the date active operations ceased for <br />the year, if any. <br />Please attach vour revised ~vrittee annual report and annual report moo to this <br />form. Please note that an adequately labeled map that clearly delineates and includes <br />the above elements may s y~ice for a written report. <br />Division records indicate the following pennittee contact information. Please verify and <br />make any necessary changes: <br />Permittee Contact: <br />Pemuttee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />~UC-a i~~1Tl-I- <br />~1-+ZIz Coo~lrtl <br />•B C 1 <br />F~16Z1~LA{{, 8D~-~-p <br />7lG .83~-4270 <br />7iR 83~-~z~s <br />If you have additional comments and/or information that should be provided to the <br />Division, please provide it below or attach it to this form along with yow written report <br />and map. Annual Repoli instructions are enclosed. <br />Signature of Corporate Officer or Owner <br />Date <br />