Laserfiche WebLink
7 <br />• <br />ANNUAL REPORT <br />PERNIITTEE NAME: iVlontrose County <br />-~ . <br />~~~ ~~z~~ <br />~ECEIVti.= <br />PERIvIITNO.: IVI-7~-yo~ MAY 141999 <br />OPERATION NAME: C E n.a R C 2 ~ ~ 1< ~'T ,.~,s:oa of MineraY~ & Geoloty <br />ANNIVERSARY DATE: l ~~O ~~`~ <br />ANNUAL FEE DUE ON ANNIVERSARY DATE: $ SSO nc <br />COUNTY: lkiontrose <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the perntit, an <br />operator shall submit the annual fee, a report and map showing the extent of curcenl disturbances <br />to affected land, reclamation accomplished to date and during the preceding year, nc;w <br />disturbances that are anticipated to occur during the upcoming yeaz, reclamation that will be <br />performed during the coming year, the dates for the beginning of active operations, ,tnd the date <br />active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this <br />annual report. Please note that an adequately labeled map that clearly delineates and <br />includes the above elements may suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone member in the <br />space provided: <br />Contact Name:~r,,o'nl YJ ~ ~Svnf <br />Address: ~ ~..+^, ~"5 ""Ff'? <br />.~rrc /? 6 i <br />/~9C~~~ro1cs~Gro Ri~/O Z <br />Company: /?~or~~Frn1o-' 1 w~ <br />PhoneNo.:(~i l~%~- 775-5- <br />Fax No.: (q70 ) ~ y `~ 7 ~ /c 1 <br />L` there are additional comments and/or information that should be provided to the Division, <br />please provide it on a sepazate sheet and attach it to this report form along with your map and/or <br />written report. <br />Signature of Corporate Officer, or Owner Date <br />~~li~r/7"] .~/ ji/~~i7 <br />/ INSTRUCTIONS ON BACK <br />