2007-02-08_REPORT - M1981287 - Laserfiche WebLink

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l7 ~ ~ /` D~ I/ RECEIVED ANNUAL FEE and REPORT REQUEST ,~ . ~,FEB 0 8 200T PERMITTEE NAME: Nikolaus Arnusch / ~ y~~un of ReGamation, PERMIT NO.: "M-1981-287 //Mining and Safety OPERATION NAME: Arnusch Grav Pit 3 ANNIVERSARY DATE: February 2S, 2007 ANNUAL FEE DUE: $$281.00 (Due on or before your anniversary date) COUNTY: Weld 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 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 of active operations, and the date active operations ceased for the year, if any. Please attach vour revised written annual report and annual report man to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated map. If no new disturbances or reclamation have occurred durinc the previous veer and no new chances to the previous year's man are necessary. then no new man is required, provided that the Operator shall state this in the Annual Report. 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: Nik Amusch AQNI./S~l-r .SQNb E ~ R1S [/EL ,t / r Permittee Name: Nikolaus Arnusch ~~ ~~ µ Mme' F ~ r ~ Ij(/ Address: 34527 WCR 6 - - Keenesburg, CO 80643 "-" - - - Phone Number: (303) 732-4427 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. Signature of Corporate Officer, Owner, or Designee ~~~ ~~ D~ Date