Laserfiche WebLink
/ ^ ._ <br />d /-~- Y' ~',P 1 <br />ANNiJAT. FF.F, and RFn.P~(1R7 <br />PERMITTEE NAME: Fremont County f"r ~` <br />PERMIT NO.: ~M-1994-118 <br />bm~ <br />OPERATION NAME: Phantom Canyon Pit <br />ANNIVERSARY DATE: August 8, 2005 <br />ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date) <br />COUNTY: Teller <br />ii- o g' <br />d~ rL/ ~ <br />~• <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 <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <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 your revised written anm~al report and anneal re,~nrt m to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since 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: Terry Action <br />Permittee Name: Fremont County <br />Address: County Commissioners <br />Ttru A~i~.,i- <br />615 Macon Ave., Room #100 <br />Canon City, CO 81212 <br />Phone Number: (719) 276-7300 _ <br />Fax Number: (719) 275-7626 <br />7/9 ~7G- yso~ <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 /> <br />Signature of Corpf•fate Officer, Owner, or Designee <br />~z,I -- <br />D~ <br />Date <br />M:IPERMl71MAS7ERDOCUMEN7SIM-AF-04 <br />