2006-09-22_REPORT - M1977301 - Laserfiche WebLink

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t.~ ~/RPM ~sC PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: ANNUAL FEE and REPORT REQUEST Colorado Lien Com any ~` M-1977-301 Roberts Quarry September 22, 2006 ~~~ ~8~~~® fP 22 orvisto„ or ?~~6 Mm~n9 antl Sa e(y gin. $688.00 (Due on or before your anniversary date) Larimer According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an 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 report and annual resort maa to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee. resort. and associated maa (All are required regardless of the level of disturbance or absence of disturbance during the previous year). Please note that an adequately labeled map that clearly delineates and includes the above elements may since for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Shelly Erickson Permittee Name: Colorado Lien Company Address: P.O. Box 440 Rapid City, SD 57709 Phone Number: (605) 342-7224 Fax Number: ~~c~~s.~~~~ If you have additional comments and/or information that should be below or attach it to this form along with your written report and map. S Signature of o rate Officer, Owner, or Designee ~~/S-o r~ Date provided to the Division, please provide Annual Report instructions are enclosed.