2006-08-31_REPORT - M1992038 - Laserfiche WebLink

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~v R~~~ ~S~ ANNUAL FEE and REPORT REQUEST PERMITTEENAME: ,/ Jones Fine Sand REG~I~~Fp PERMIT NO.: t/ M-1992-038 '~AUG 312006 OPERATION NAME: Sand Creek Mine Division of Reclamation, ANNIVERSARY DATE: September 1, 2006 Mining and Safety ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date) COUNTY: Adams According to C.R.S. 34-32.5-116 or C.R.5. 34-32-116, each year, on the anniversary date of the permit, an operator shall- ~!bI!rit-the-annual -feeTa=report-and- map -shotvina._th°-extenUaf Darren±. disturbances-to_aff cted land, reclamation accomplished to date and during the preceding yeaz, 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 report maa to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, resort, and associated mau (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 suffice for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Dazen Palizzi Permittee Name: Jones Fine Sand Address: 5400 Forest St. Commerce City, CO 80022 Phone Number: (303) 289-1428 Fax Number: If you have additional comments and/or information that should be provided to the Division, please provide it below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. ~r~/~ ~ . Sig~nyature of Corporate Officer, r, or Designee D-o~Q-~~D Date