2006-09-28_REPORT - M1980205 - Laserfiche WebLink

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~~ J b -' ~ ~M ~~l RECEIVED PERMITTEE NAME: / Select Materials / 4FP ? R 7~f15 PERMIT NO.: ~ M-1980-205 v Division of Reclamation / `~ , Mining and Safety OPERATION NAME: Select Materials ANNNERSARY DATE: October 2, 2006 ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) COUNTY: Weld 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 I shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur dun`ng the'upcomirig year; reclamation Thal witl-be perfomted during the coming year, the dates for the beginning I of active operations, and the date active operations ceased for the year, if any. Please attach your revised written annual report and annual report map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated map. If no new disturbances or reclamation have occurred durinc the previous vear and no new chances to the previous year's map are necessary, then no new map is required, provided that the Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Robert D, Oman Permittee Name: Address Select Materials P.O. Box 280 Fort Lupton, CO 80621 Phone Number: (303) 857-4688 Fax Number: (303) 857-4638 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. ~ti~~ Officer, Owner, or Designee Date