2007-09-11_REPORT - M2004030 - Laserfiche WebLink

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~~ ~-Q~T ANNUAL FEE and REPORT RE UEST~ PERMITTEE NAME: T Bone Stone, Inc. PERMIT NO.: M-2004-030 OPERATION NAME: T Bone Stone Quarry ANNIVERSARY DATE: September 13, 2007 ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) COUNTY: Boulder RECEIVED SEP 1 12007 /pfvlsion of ReGametbn. ~( fUlltln8 and Safety 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, --rcC1@A]@t:,•« ,•9#R~1~3F~6~-10 dAt@-'1#rGl Gtlslag }• ,~ Vf (~fi h kt~ t tlC_~s~l~~\06CAiT- 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 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, resort, and associated man. If no new disturbances or reclamation have occurred during the arevious veer and no new chances 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: Permittee Contact: Bill Tenore Permittee Name: T Bane Stone, Inc Address: 2337 Emery St Longmont, CO SO501 Phone Number: (303) 324-5021 Fax Number: (303) 776-3839 If you have additional comments and/or information that should be below a o this o along with your written report and map. gnature of Corporate Officer, Owner, or Designee provided to fhe Division, please provide it Annual Report instructions are enclosed. Date