Laserfiche WebLink
~fY. <br />PERMTTTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />Rio Grande County <br />M-1978-065 <br />Seven Mile Plaza <br />October 22, 2002 <br />$281.00 (Due on or before your anniversary date) <br />Rio Grande <br />RECE~uEp <br />c:; t , ~ , <br />Division of Minerals and Geology <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 />^perator-shall-submit-the-annual-fee,-a-report-and-msp-showing-the-extent-of current disturbances ta-affected-- - - <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated [o <br />occur during [he 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 annual report and annual reuort 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: Lawrence "Buddy" Shaver <br />Permittee Name: Rio Grande County <br />Address: 168 N. Washington <br /> Monte Vista, CO 81144 <br />Phone Number: (719) 852-4781 <br />Fax Number: (719) 852-0305 - - - _ - - - - <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 />Signature of Corporate Officer, Owner, or Designee <br />lCJ-/7- O Z_ <br />Date <br />M:IPERMITU1ASTERDOC UMENTSU-I-AF-09 <br />