Laserfiche WebLink
<br />it <br />~` ~ <br />ANNfiAi. FF.F, and RF.PnRT RF,t7iTFST <br />.~ B'vh <br />PERMITTEE NAME: Baca Couuty <br />PERMIT NO.: t/1~4-1977-479 <br />OPERATION NAME: Walsh Pit No. 2 <br />ANNNERSARY DATE: September 11, 2005 <br />ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) <br />COUNTY: Baca <br />~-~i-D~ <br />~~ <br />~D~~ <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 disiurtiances 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 attach ynnr revised written anneal rennrt and anneal re~nrt m to this form. Please note that an <br />adequately labeled map that clearly delineates and ir:cludes 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: ``11 y1~ <br />Permittee Contact: ~1~ ~ ~• ~~ ~1 ' l,~ <br />Permittee Name: Baca County <br />Address: 741 Main St. <br />Phone Number: <br />Fax Number: <br />Springfield, CO 81073 <br />(719)523-6532 <br />(719)523-6584 <br />/i <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 />Date <br />8 ' OS <br />M:SPERMITVv1ASTEADOCUMENTSNI-AF-6M1 <br />