Laserfiche WebLink
<br />~ III IIIIIIIIIIIII III ~ <br />ANiyuy,, n;:~ ~,~.~ R~CEIVFr <br />PERMITTEE NAME: Sedgwick County Divi n' ,J <br />PERMIT NO.: M-96-073 SO~ettdtnerabgGeology <br />OPERATION NAME: Dolezal Gravel Pit <br />ANNNERSARY DATE: November 08, 1999 <br />ANNUAL FEE DUE ON ANNNERSARY DATE: $225.00 ~.~ ~ ~~ <br />COUNTY: Sedgwick <br />According to C.R.S. 34-32.5-1 l6(3)la), 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 <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are <br />anticipated to occur during the upcoming year, reclamation that will be performed during the coming <br />year, the dates for the beginning of active operations, and the date active operations ceased for the year, <br />if any. <br />Please attach your revised annual report map and written report to this annual report. Please <br />note that un adequately labeled mnp that clearly de[inentes turd inchtrles the ubove eletnents may <br />since 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 />Compan}~ ~(~l(t' ~ ~G~~Q~ <br />Phone Nory: (~ ~ . ~~ 7 `E' <br />Far No.: hi'!~ ~7~' ~SS~ <br />If there are 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 />~ ~~ ~ ~ ~ ~~ <br />Signature of Corporate O tcer, or Owner D to <br />INSTRUCTIONS ON BACK <br />