Laserfiche WebLink
- ~° <br /> <br />REG~I~~'~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Saguache County <br />M-1995-075 <br />Coleman Pit <br />April 25, 2004 <br />$688.00 (Due on or before your anniversary date) <br />Saguache <br />MAR 2 4 2004 <br />Oirision of Minerals and GeoloAY <br />According to C.R.S. 34-32.5-116 or C.R_S. 34-32-116, each year, on the anniv_etSary date_of_the~permiL,<an_ -- ~-- <br />" operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach ynnr revised written ennnal r~nrY and annnal re~nrt maT fn this form. please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: John T. Ungefug <br />Permittee Name: Saguache County <br />Address: P.O. Box 476 <br />Saguache, CO 81149 <br />Phone Number: (719) 655-2554 <br />Fax Number: (719) 655-2534 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />Signa a of Corporate Officet er, r esignee <br />Da[e <br />M:IPERMITMASTERD000MENTSN-I-AF-0d <br />