Laserfiche WebLink
n~~ <br />~S <br />~~~~1~/ED <br /> ANNTiAT, FF.F. and RF,Pt7RT RF./1TTF.ST <br /> <br />PERMITTEE NAME: <br />PERMIT NO.: /. Benson Brothers - - <br />/ M-2004-084 <br />OPERATION NAME: Benson Brothers Pig Mesa Pit <br />ANNIVERSARY DATE: May 5, 2006 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Delta <br />~~~!MAY 0.126 <br />" Division o} Minerals acid Gealogp <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 the annual fee, a report and map showing the extent of current disturbances to affected land, __ <br />reclama"lion aecomplished'to date and-during ttie 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 your revised written annnal rennrt and annnal re nn rt main to this form- Please note [hat an <br />adequately labeled map that clearly delineates and includes the 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: Ed Benson <br />Permittee Name: Benson Brothers <br />Address:-2134 J50-Rd- o? % ~ <,/~ ~L/p.~iie /C~~ ~ <br />Austin, CO 81410 <br />Phone Number: (970) 835-3128 <br />Fax Number: ~ ~ 83J` - ~ J~~o 7 <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. Annual Report instructions are enclosed. <br />Signature of Corporate Of icer, Owner, or Designee <br />~/-~~ d~ <br />Date <br />