2008-01-24_REPORT - M1986004 - Laserfiche WebLink

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~~~ ANNUAL E and REP~RT RE VEST o ~~~~~s PERMITTEE NAME: Harold Brandstadt PERMIT NO.: ~-1986-004 OPERATION NAME: Brandstadt Rock Pit ANNIVERSARY DATE: January 24, 2008 ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) COUNTY: Delta According to C.R.S. 34-32.5-116 or C.RS. 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, rerlama~iori -acca~p~fished-to~ate-and =during_the_.preceding ye~r~ new_ disturbances that are anticipated to occur during the upcoming year, reclamation that will be performed during the coming year;~t~`ie dates for the-fiegimm~g-- - -- of active operations, and the date active operations ceased for the year, if any. Please attach your revised written annual report and annual report man to this form. The Annual Report & Fee requirement is not met until we have received the following components• fee, report, and associated neap. If no new disturbances or reclamation have occarred during the previous veer and no new_chanaes to the previous year's man are necessary, then no new man is required. 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 since for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Harold Branfdss/tadt /~ ` ,~ ~ ,c., Permittee Name: Harold Brandstadt Address: 20426 G Rd. Delta; CO 81416 Phone Number: (970) 874-4159 Fax Number: If you have additional comments and/or information that should be provided to the Division, please provide it below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. Signature of Corporate Officer, Owner, or Designee ~ - D ~. .