Laserfiche WebLink
9 <br />ANNUAL FED a d P/RT REpUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNiJAL FEE DUE: <br />COUNTY: <br />/ Nichols Gravel Pit, L.L.P. <br />~M-1981-013 <br />Nichols Gravel Pit <br />October 21, 2007 <br />~~®~ <br />Gov z s zoo? <br />Di ision of Reelamatfon, <br />Mining and Safety <br />$$791.00 (Due on or before your anniversary date) <br />Mesa <br /> <br />- -Acco~lir.~ t^ C:R~: 34-3?.5--1-I6-or_C_i_~,5._3.4_3.2T1.16,_each_~eaz,_on the anniversa~ date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />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 map to this form. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's map are necessary, then no new map is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: John Nichols <br />Permittee Name: Nichols Gravel Pit, L.L.P. <br />Address: P.O. Box 285 <br />Mesa, CO 81643 <br />Phone Number: (970) 268-5525 <br />Fax Number: (970) 268-5732 <br />1.1 e ~ ~csl~.~.~ ~~J~ T~-~ <br />~~L J , <br />rzf' 1 /,~ ~ t'~:f~ ~' ~z~,sh /i ~~' <br />,~ y' _ <br />~~~ <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 enclosed. <br />Si ature of Corporate Officer, Owner, or Designee <br />/ 27 0 <br />Date <br />