2007-05-14_REPORT - M1978327 - Laserfiche WebLink

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ANNUAL FEE and REPORT REQUEST PERMITTEE NAME: ~ Jake Kauffman & Son, Inc. ' _ • ~ ~ 9' PERMITNO.: ._M=1978-327 ~ ~ ~ ,! °. "4F Di„;, ; , ~~(ii M 0, OPERATION NAME: Kauffman Pit ~_~h~n ° ; :~,- , .. ~ ,pro; 8 anL Sai~iy ANNNERSARY DATE: May 14, 2007 ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date) COUNTY: Larimer _ 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~o affected land, reclamation accomplished to date and during the preceding year, 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 far the year, if any. Please attach Your revised written annual report and annual report map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, reuort, and associated map. If no new disturbances or reclamation have occurred durinti the previous veer and no new chanties to the previous year's map are necessary, then no new map 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 since for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Pennittee Contact: Mary Kauffman Permittee Name: Jake Kauffman & Son, Inc. Address: 808 SCR 9E Loveland, CO 80537 Phone Number: (970) 667-1557 Fax Number: (970) 667-9985 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. ~=~'-D7 Date