2006-06-08_REPORT - M1996031 - Laserfiche WebLink

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55 S PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: ANN1fiAT. FF.F, and RF.P(lRT RF.t7iTFST d /Sutherland Brothers, Inc. t~ M-1996-031 Weimer No. 2 July 2, 2006 ~~CEI~lED /JUN 0 8 Z0~ ~' Oivlsion of Mlnerala antl OeolaBY $281.00 (Due on or before your anniversary date) Montrose According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date ofthe permit, an operator shall submit-the annual fee; a-report and map showing the extent of current disturbazices to-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 for the year, if any. Please attach xQnr revised written anneal report and anneal re on rt martn this form. The At,nual Report & Fee requirement is not met until we have received the following 3 components: ss, re_nnrt, and associated map (A113 are required regardless of the level of disturbance or absence of disturbance during the previous year). 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 permittee contact information. Please verify and make any necessary changes: Permittee Contact: Bob Sutherland Permittee Name: Sutherland Brothers, Inc. Address: CF.PR.address 1 P.O. Box 889 Nucla, CO 81424 Phone Number: (970) 864-7662 Fax Number: (970) 864-7980 If you have additional comments and/or information that should be provided to the Division, please provide it belo ~ r attach it to this form along with your written report and map. Annual Report instructions are enclosed. ~, Signat~ of Corpo ate Officer, Owner, or Designee C~o -(o -nC~ Date