Laserfiche WebLink
<br />_~ <br />a <br />~~kra83a,S" ~~~~g•oo <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br /> <br />ANNUAL FEE and REPORT REQUEST <br />Elbert County <br />M-1988-101 <br />Fondis Pit <br />December 15, 2000 <br />~~~~ ~ (Due on ar before your anniversary date) <br />Elbert <br />DEC 1 1 2000 <br />Division of Minerals and Geology <br />According [o C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on [he anniversary date of [he permit, 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 [Ite 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 your revised written annual report and annual report man to this form. P/ease note drat an <br />adequately labeled nrap drat c/early delineates crud inchrdes the above elements uurv suffice jot n written <br />report. <br />Division records indicate the following periittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: -Pam right- /~ /a ~1 ~ua. ~P~~ <br />Permittee Name: Elbert County ~ ~ / <br />Address: --R--6-~Bm-1~16 ~j Q ~"( t~lt-~ <br />c~. +~~a ,~CiX3~ <br />-iEivwa-E6~-801 17 <br />Phone Number: .(~I ~9 7/ 9- ~ 5~~ -~1~ ~ <br />Faz Number: (~ 7/ 9- _7 `~~-.2~f~~ <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 />6~ ~~~~ <br />Signature of Corporate Officer or Owner <br />~~- ~ `dam <br />Date <br />M.WERMnUAASTERD000MENI'SUA-AF-0i <br />