Laserfiche WebLink
~~ ~-Q~T <br /> ANNUAL FEE and REPORT RE UEST~ <br /> <br />PERMITTEE NAME: T Bone Stone, Inc. <br />PERMIT NO.: M-2004-030 <br />OPERATION NAME: T Bone Stone Quarry <br />ANNIVERSARY DATE: September 13, 2007 <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Boulder <br />RECEIVED <br />SEP 1 12007 <br />/pfvlsion of ReGametbn. <br />~( fUlltln8 and Safety <br />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 <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />--rcC1@A]@t:,•« ,•9#R~1~3F~6~-10 dAt@-'1#rGl Gtlslag }• ,~ Vf (~fi h kt~ t tlC_~s~l~~\06CAiT- <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, resort, and associated <br />man. If no new disturbances or reclamation have occurred during the arevious veer and no new chances to <br />the previous year's map are necessary. then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Bill Tenore <br />Permittee Name: T Bane Stone, Inc <br />Address: 2337 Emery St <br />Longmont, CO SO501 <br />Phone Number: (303) 324-5021 <br />Fax Number: (303) 776-3839 <br />If you have additional comments and/or information that should be <br />below a o this o along with your written report and map. <br />gnature of Corporate Officer, Owner, or Designee <br />provided to fhe Division, please provide it <br />Annual Report instructions are enclosed. <br />Date <br />