Laserfiche WebLink
JAN-12-2005 15:47 (=RDM:CDOT MRTERIRLS LRB 303-757-9008 70:9702467292 P.011'01~ <br />i <br />I <br />I <br />ANNiiAi. TiRF, Antl RFPia. T RF. JF.CT <br />~.: ~ ~ .....J <br />PERMITTEE NAME: Colorado Division of >Fllghvaays <br />PERMTf NO.: M-1981.043 <br />OPERATION NAME: N Of Douglas Pass <br />ANNIVEILSARY DATE: February 1, 2005 <br />ANNUAL FEE DUE: $281.00 (Due nn or before your anniversary date) <br />COUNTY: liio 131amco <br />According to C.R,S. 34-32.5-11G or C.RS. 34-32-116, each yea;, on the anniversary date of the pcrttrit, an <br />operator skull submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamralioit accotnplisTied to dale and during the pieceding year, new~disltrrbanacs~+at are anticipated fo <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operatons ceased for the year, if any. <br />Ptcacc ntta~h y~nnr revGeod written an~p] rg~Rr~.anf~ annnel rpp mop to thin form. please Hate tltal an <br />adequately labe!¢d map tAar clearly delineates and includes the a5ove elements may sake for a written <br />reparl. <br />Division records indicate the following pcrmitbce contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: ,Eric Peeve <br />Permittee Pfarne: Colorado Division of FIighways <br />Address: 4340 E. Louisiana Ave. <br />Denver, CO 80222 <br />P.honc Number: (303) 75'1-9269 <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Aratual .Report instructions are <br />enclosed. <br />Signature of Corporate OfAccr,Owner, or Designee <br />Dote <br />~~o~, <br />.~„~ <br />~ ~~ <br />a <br />2~o H <br />I,t,~u r <br />MaPIiRMS7M1MM4'gsRpp~fJMl7i'($lM•AF-04 <br />