Laserfiche WebLink
~~% I 1 <br />ANNUAL FEE and REPO T REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Horizon Ranch, LLP <br />`~M-1997-084 <br />Memphis <br />February 2,2007 <br /> <br />'~~~ ~ 61001 <br />~rvlaian Atr?~ai~fOdti®R, <br />M!ryinp dRd l~df@iy <br />$$281.00 (Due on or before your anniversary date) <br />Ouray <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 operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation aocomplished to date and during=the=preceding year,-new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />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. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred durin¢ the previous year and no new changes to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes; <br />Permittee Contact: Reef Gillum <br />Permittee Name: Horizon Ranch, LLP <br />Address: P.O. Box 190 <br />- Forney, TX 75126- ~ - - _ -- - <br />Phone Number: (972) 303-9010 ~ ~ a - a a ~ - ~ a ~ <br />Fax Number: (972) 303-9030 ~ 1 ~' ~a~ (n - ~ ^1 r(1 Z-- <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 aze enclosed. <br />Officer, Owner, or Designee <br />Date <br />