2007-12-10_REPORT - M1982015

• Permit No: M1982015
• IBM Index Class Name: REPORT
• Doc Date: 12/10/2007
• Doc Name: Annual Fee/Report/Map
• From: Carma Bayshore LLC
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

~I ,
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNiJAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Carma Bayshore LLC
M-1982-015
St. Vrain Lakes, Filing 1, Slurry Wall
December 10, 2007
$$791.00 (Due on or before your anniversary date)
Weld
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 operator
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
-- - reclamation-accompli-shed--to date-and-during-the-preceding-year,-new-distur-bances-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 your revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
map. If no new disturbances or reclamation have occurred durinE the previous year and no new chanEes to
the previous year's map are necessary, then no new map is reauired, provided that the Operator shall state
this in the Annual Report. 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: Tyler Packard
Permittee Name: Carma Bayshore LLC
Address: 188 Inverness Dr. West, Ste. 150
Englewood, CO 80112
Phone Number: [phone]
Fax Number: [phone]
you h e additional comments and/or
loyv ttach it to this forte along with ;
Signature of Corporate Officer, Owner, or
that should be provided to the Division, please provide it
report and map. Annual Report instructions are enclosed.
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Date