2007-05-22_REPORT - M1986048 - Laserfiche WebLink

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~~~~ Pi ANNUAL FEE and REPORT REQUEST PERMTI"fEE NAME: PERMIT NO.: OPERATION NAME: ANNNERSARY DATE: ANNUAL FEE DUE: COUNTY: Reese Contracting "M-1986-048 Nicholson Gravel Pit May 22, 2007 I~d~f`~''~ ~r~ r.- ~~ <~, ? `' 2007 DNf:;!un ~ ' Af~iniR ~ ~ ~ ~.,. JOn, s rn., .:~;qty $$688.00 (Due on or before your anniversary date) Morgan 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 sha71 subm-it the annual-fee`a report and map sfiowing tTie exten[ of current-disturbances to aY ecT tie - 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 for the year, if any. Please attach vour 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, report. and associated map. If no new disturbances or reclamation have occurred durine the previous year and no 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 pennittee contact information. Please verify and make any necessary changes: Permittee Contact: Galen Reese Permittee Name: Reese Contracting Address: P.O. Box 105 Atwood, CO 80722 Phone Number: (970) 522-0867 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 enclose ~~~~~ Signature of Corporate Officer, Owner, or Designee S- ~n - Date M:~PERMITMASTERDOCUMENTSIM-AF-04