Laserfiche WebLink
~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Green Brothers, Inc. <br />M-1995-030 <br />Green Bros Pit No 2 <br />Jnly 7, zoo~T <br />.__ / N <br />N <br />RECEt~ED <br />AUG 2 ~ 2004 <br />D"ixisio~'~ i <br />$281.00 (Due an or before your anniversary date) <br />Morgan <br />According to C.R.S. 34-32:5-176 or C.R.S. 34-32-I 16; each year, on rite anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />grin the u'-omm ear, reclam`atio'n"mat wilTfie erldrmed-dunn f3ie comlii """' " <br />-- -- 8 ~__. 8 y ~ 8 8 ;/ear; ifie"c3aTe`s~or~tfie Seginaing' _` <br />of active aperations, and the date active operations ceased for the year, if atty. <br />Pleece attach your revises Lvritten anmrel r4nnrtend annnal renort men M,(h}g_form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements miry su~ce,for a written report. <br />Division records indicate the following petmittee contact information. Please verify and snake any necessary <br />changes: <br />Petmittee Contact: Jim F. Green <br />Petmittee Name; Green $rothers, Inc. <br />Address: 39447 U.S. Awy. 34 <br />P.O.13ax 858 <br />Ft Morgan, CO 80701 <br />Phone Number: {970) 667-2404 <br />-Faz1Vu`inber: {9'fi)Bb7-2-~35_. -.---- .__.__.__._,_.__----...-____- .._ ~_.___. ___...__. - <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 this form along with your written report and snap. Annual Report instructions are enclosed. <br />~ c._.-J , <br />Sig~ature of Corporate tees, Owner, or designee <br />Date <br />M:IAGRM7r1MA3TERDOCUMENTSVv1-AF-0I <br />