Laserfiche WebLink
- - ~ III IIIIIIIIIIIII III ~ ~~~ <br />sss - . G~ <br />ANNUAL REPORT •,~,,P~~O~O~ <br />PERMITTEE NAME: David Goss ~~~`0°0`~\~~ <br />PERMIT NO.: M-1985-140 ~ <br />OPERATION NAME: Goss Sand & Gravel <br />ANNNERSARY DATE: January 24, 2000 ®~ <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $225.00 LLL~~iiiiii <br />COUNTY: EI Paso <br />According to C.R.S. 34-32-116(3)(a), each year, on the anniversary date of the permit, an operator shall <br />submit the annual fee, a report and map showing the extent of current disturbances [o affected lan3- - - - <br />reclamation accomplished to date and during the preceding yeaz, new disturbances that are anticipated <br />to occur during the upcoming year, reclamation that will be performed during the coming yeaz, the <br />dates for the beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note that nn adequntely labeled map that clearly delineates and includes the nbove elements may <br />suffice for a written report. <br />Please type or print the current contact person's name, mailing address, and phone number in the space <br />provided: <br />Contact Name; 1J~VlOI [7/J~S,1S~ Company: 71 D_SS ~Nd `~C~i~?/E~ <br />Address: ~a ~S9 ~~~~ Gt0 IT 17 r1 Phone No.: ( ~i4 ~ G 8.~- a yi~r <br />~,4-/1~,4-w ~o' ~b~b~ FAx No.: f 7/y ~ ~~3 -3a y~ <br />If there aze additional comments and/or information that should be provided to the Division, please <br />provide it on a separate sheet and attach it to this report form along with your map and/or written <br />report. <br />l° <br />,~,~=Da <br />Signat re of Corporate Officer, or Owner Date <br />INSTRUCTIONS ON BACK <br />MINER M IT\M ASTERDOCU S1 ENrSU1-AF-01 <br />