Laserfiche WebLink
~~ ~~ <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNNERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />brn l~ <br />ANNTiAT, FF.F, and REPORT RF.nTiF.ST <br />Kit Carson County <br />/~M-1982-189 <br />Hornung Pit <br />October 28, 2005 <br />RECEIVED <br />~EP282~ <br />'~ Oivisi~,. ,;i ,Egiaerals and Gaol <br />aYY <br />$281.00 (Due on or before your anniversary date) <br />Kit Carson <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 tiie extent Uf 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 />begiming of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written anm~al report and annual report m ~n 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 />P <br />itt <br />C <br />t <br />t L <br />d <br />B <br />f <br />ld ~ y <br />erm <br />ee <br />on <br />ac <br />: yn <br />a <br />rown <br />ie <br />IV <br />Permittee Name: Kit Carson County <br />Address: P.O. Box 160 <br /> Burlington, CO 80807 <br /> 2 G <br />~~ <br />Phone Number: (719) 346 <br />J I <br />Fax Number: <br />l <br />(719) 346-7242 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach }t~ to this form along with your written report and map. Annual Report instructions are <br />enclosed. ~ f <br />,Owner, or Designee <br />s7 <br />Date <br />M:~PERMITN1ASTERDOCUMENTS~M-AF-04 <br />