2007-01-30_REPORT - M1977534 - Laserfiche WebLink

Home Browse Search

~~~ ~P-~ PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNNERSARY DATE: ANNUAL FEE DUE: COUNTY: ANNUAL FEE and REPORT REQUEST /'City of Golden ~M-1977-534 Empire Pit January 30, 2007 „dp,~ a 0 2001 $$688.00 (Due on or before your anniversary date) Clear Creek operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to 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 vour revised written annual resort and annual report maa to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated man. If no new disturbances or reclamation have occurred durinc the previous vear and no new chances to the previous year's man are necessary. then no new map is required, arovided that the Operator shall state this in the Annual Resort. 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: Pennittee Contact: Dan Hartman Permittee Name: City of Golden Address: Director of Public Works 9L1 Tenth St._ __ ____ __ _ _ Golden, CO 80401 Phone Number: (303) 384-8000 Fax Number: (303} 384-8161 If you have additional comments and/or information that should be provided to the Division, please provide iY below or attach it to this form along with your written report and map. Annual Report instructions aze enol sed. / ~.5.. ~ Signature of Corporate Officer, Owner, or Designee i-gig-o7 Date M:IPERMn1NASTERD000MEN7SIM-AF-04