2006-08-22_REPORT - M2004026 - Laserfiche WebLink

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~~;r PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: ~ ANNUAL FEE and REPORT REQUEST v /Leone Sand and Gravel, LLC M-2004-026 Leone Gravel Pit August 25, 2006 RECEIVED ~~ auc z z zoos ~/ uivision of Reclamation, Mining and Safety $688.00 (Due on or before your anniversary date) Las Animas Mme' g~~ 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 shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, reclamaticn accomplished-to-date and-during-the preceding-yeaz,-pew- disturbances-that-are.anticipated~o occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active operations, and the date active operations ceased for the year, if any. Please attach your revised written annual report and annual resort maa to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated map (All are required regardless of the level of disturbance or absence of disturbance during the previous year). 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: Frank L. Leone Pennittee Name: Leone Sand and Gravel, LLC Address: 502 S. Walnut St. Trinidad, CO 81082 Phone Number: (719) 846-4170 Fax Number: (719) 846-0605 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. Signature of Corporate Officer, Owner, or Designee Date