Laserfiche WebLink
:r <br />PERMITTEE NAME: <br />PERMIT NO.: <br />ANPf~7Ai: FE~an~R~ O/R,I, REQUEST <br />- Belvedere Stone, LLC <br />,/M-1991-147 <br />~~ <br />r AUK 1®2007 <br />Livision of keciarnaNon, <br />Mining and Safety <br />OPERATION NAME: Belvedere Stone Quarry <br />ANNIVERSARY DATE: July 16, 2007 3~-j <br />ANNUAL FEE DUE: $~0 (Due on or before `you-r anniversary date) <br />COUNTY: Douglas <br />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 <br />- - shall submit t-iie -annual-fee, a report and map showing the extent of cuirent disturbances to affec[ed land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual reuort and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, resort, and associated <br />ma If no new disturbances or reclamation have occurred durinc the arevious year and no new chances to <br />the previous year's man are necessary, then no new man is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: William G. Johannsen <br />~~0 ajLS ~..vv y !~6-iv[ 6% <br />Permittee Name: Belvedere Stone, LLC <br />Address: 2635 Steel Dr. <br />Colorado Springs, CO 80907 <br />Phone Number: (719) 471-9396 <br />Fax Number: <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 map. Annua] Report instructions are enclosed. <br />Signature of r orate Officer, Owner, or Designee <br />~/9~G,~ <br />Date <br />