Laserfiche WebLink
<br />~ ~~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Park County <br />M-1980-019 <br />HaII Gulch Pit <br />April 1, 2004 <br />$281.00 (Due on or before your anniversary date) <br />Park <br /> <br />MAR 3 0 2004 <br />Division of MirerIs E Geulogy <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, areport-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 ynnr revised written annnal rvpnrt and annnal re~nrt maT to his form. please note that an <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: Doug Keith %~„y,«7 yr~,~c.e_ <br />Permittee Name: Park County <br />Address: P. O. Box 147 <br />Fairplay, CO 80440 <br />Phone Number: (719)836-4283 ('`I(Q~ ~63t~ ~zssz <br />Fax Number: (719) 836-4275 <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 />Signature of Corporate Officer, Owner, or Designee <br />3/z 9 /04 <br />Date <br />M:,PERMITMAS7EADOCUMENPSVN-AF-04 <br />