Laserfiche WebLink
Y-" <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNP/ERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Rio Blanco County <br />M-1998-054 <br />East Douglas Creek Gravel Pit <br />October 5, 2004 <br />~~ <br />6'll 4G~.o lb.u <br />OCT 2 ` ZC04 <br />Division of l6iineraia " " - ~ ~•~'J <br />$281.00 (Due on or before your anniversary date) <br />Rio Blanco <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 />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <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 attachn~r revised written annual rennrt and anneal re nn rt m ~n 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: Start}ey Rasmnsserr- <br />Permittee Name: Rio Blanco County <br />Address: 1.749-69-SIi--64 <br />Phone Number: (9~9}fr73~5~14 <br />Fax Number: (~8~6~5=5'il l <br />~o1J l..eer~~ <br />570 - se~o.,a st• <br />Mcr~r, Go 8 t L ~r <br />970 - 878- a~[oo1 <br />970 - 878 - 3 39 (p <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 fficer, Owner, or Designee <br />4' ~~-1- -0 `/ <br />Date <br />M:~PERMInMASTERDOCUMEN7'S4M-AF-04 <br />