Laserfiche WebLink
<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Chaffee County <br />M-1978-192 <br />Pit No 6 <br />June 30, 2003 <br />$281.00 (Due on or before your anniversary date) <br />Chaffee <br />~F~ <br />~s,~ ,,`~ <br />F_ <br />`~. <br />o: <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, reclam`ahon 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 yn ~r revised written annual rennrt and_ann~ rennrt man fn this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice 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: Joe Nelson <br />Permittee Name: Chaffee County <br />Address: 102 Crestone Ave. <br />Salida, CO 81201 <br />Phone-Number: (7-b9) 539-6961- --- -- -- <br />Fax Number; (719) 539-7442 <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 />Sign e f Corporate O ~cer, Owner, or Designee <br />5-i31 -ol <br />Date <br />M;\PERMITMASTERDpCUMENTS\M-A F-O6 <br />