Laserfiche WebLink
ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />City of Colorado Springs <br />M-1989-116 <br />Crystal Pit <br />March 26, 2002 <br />RECEI~IED <br />APR 0 3 2002 <br />Division of Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Teller <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on [he anniversary date of the permit, an <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land; reclamation accontpiished to date and-during the prec eding year, naw disturbances iiiat are anticipated to - - <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for [he year, if any. <br />Please attach vour revised written annual report and annual report maa to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records in dicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Petmittee Contact: Dave D. Jordan <br />Perrnittee Name: City of Colorado Springs <br />Address: P.O. Box 1575 <br /> Mail Code 060 <br /> Colorado Springs, CO 80901-] 575 <br />Phone Number: (719) 385-7715 <br />Fax Number, (7l9) 684-2234 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach i[ to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />[~-'il.vt 1~.--.- ~i <br />Signature of Corporate Officer or Owner <br />.bZ- ~ ZS'OZ <br />Date <br />M:~PERMI"IVNASTERDOCUMENTSIM-AF-p4 <br />