2008-02-29_REPORT - M1992074

• Permit No: M1992074
• IBM Index Class Name: REPORT
• Doc Date: 2/29/2008
• Doc Name: Annual Fee/Report/Map
• From: City of Colorado Springs
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

PERMTI"TEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL E`E and ~ ORT RE UEST
City of Colorado Springs
~-1992-074
Ciear Spring Ranch Pit
March 12, 2008
IVED
/ ~~~~ 2 9 200$
Il4fslbn oTN.eclamation,
1Minirtg and Safety
$$791.00 (Due on or before your anniversary date)
EI Paso
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 accomplished to date and during the preceding year, new disturbances 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 vour revised written annual report and annual report map to this form The Annual
Report & Fee requirement ~s not met until we have received the following components: fee. report. and
associated map. If no new disturbances or reclamation have occurred Burin the revious ear and no
new chances to the previous year's map are necessary then no new map 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:
Permittee Name:
Address:
Phone Number:
Fax Number:
Jenny A. Gray
City of Colorado Springs
P.O. Box 1103
Mail Code 940
Colorado Springs, CO 80947
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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.
f
Signature of C rpor fficer, Owner, or Designee
Date
M:~PERM ITUNASTE RDOCUMENTSUI4-AF-04