Laserfiche WebLink
999 <br /> ANNUAL FEE and REPORT REQUEST <br /> PERMITTEENAME: Montezuma County F—EC EI ED <br /> PERMIT NO.: >M-1478-107 , �I 2 n 7903 <br /> OPERATION NAME: fpm <br /> ANNIVERSARY DATE: November 2,2000 Division of'...nc. la and Geology <br /> ANNUAL FEE DUE: $688.00(Due on or before your anniversary date) <br /> COUNTY: Montezuma <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 attach your revised written annual report and annual report map to this form. Please note that air <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: Lloyd Everett <br /> Permittee Name: Montezuma County <br /> Address: 1680 Hwy. 145 <br /> Cortez, CO 81321 <br /> Phone Number: (970) 565-8666 <br /> Fax Number: (970) 565-8252 <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 /> S' atu a of eorp/orate Officer or Owner <br /> 1 t ,7 <br /> Date <br /> M TERM ffNIASTERDOCUMENTSW-AF-OJ <br />