Laserfiche WebLink
/rf-=~;P-7- <br />_:. <br />~ e <br /> ANNiJAi, FF.F. and RF.PnRT RF.niTFST <br />PERMITTEE NAME: M <br />ontezuma County <br /> / <br />PERMIT NO.: t/M-1978-107 <br />OPERATION NAME: Tozer Pit <br />ANNIVERSARY DATE: November 2, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Montezuma <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 <br />land, reclamation accomplished to date and during the preceding year, new disturbances that 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 the year, if any. <br />Please attach your revised written anneal re~nrt and anm~al re ern t man 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 indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Lloyd Everett <br />Permiuee Name: Montezuma County <br />Address: 1680 Hwy. 145 <br />Cortez, CO 81321 <br />Phone Number: (970) 565-8666 <br />Fax Number: (970) 565-8252 <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 <br />enclosed. <br />S ature f Corporate Officer, Owner, or Designee <br />~ ~ g ~~ <br />Date <br />~~ c~~ <br />~~~~~~ <br />~~~ u,',~ <br />M iPERMIT~MASTERDOCUMENTSUv1-AF-04 <br />