2006-12-27_REPORT - M2004053 - Laserfiche WebLink

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rc D PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNNERSARY DATE: ANNUAL FEE DUE: COUNTY: vANNUAL FEE and REPORT REQUEST /Rivera's Excavation I/ M-2004-053 Riveras Excavation Gravel Pit December 29, 2006 RECE~1/ED DEC 2 7 2006 vision of Reclamation, Mining and Safety $$281.00 (Due on or before your anniversary date) Costilla 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 the annual fee, a report and map showing the extent of current disturbances to affected land, reclamation-a~i,complish~d'to date=and during tlfe preceding year, new di"stuTbances ai are an icipated~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 resort map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, resort. and associated map. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to the arevious year's maa are necessary, then no new map is required, provided that the Oaerator shall state this in the Annual Resort. Please note that an adequately labeled map that clearly delineates and includes the above elements may since for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary - changes: Permittee Contact: Eleuto J. Rivera Permittee Name: Rivera's Excavation Address: POB 24 Amalia, NM 87512 Phone Number: (SOS) S86-lOS9 Fax Number: If you have additional comments and/or information that should be provided to the Division, please provide it below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. Signature of Corp rat~icer, Owner, or Designee ~~~ Date