Laserfiche WebLink
Fmk <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME,: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />,~ ~ <br />~~ <br />A-1yP~LTAL FEE an REPORT REQUEST <br />~~~~d~~ <br />i <br />Kit Carson County <br />M-1989-004 <br />Raymond Duell Pit <br />Apri126, 2008 <br />~1AR 31 200r'~ <br />~0ivision ofa d Safety n, <br />Mining <br />$$323.00 (Due on or before your anniversary date) <br />Kit Carson <br />_ _ , According to C.R:S- 34=3-2:5-=116- orC.R:S. 34-32-11-6, each year; on the anniversary date -of the permit, an <br />operator shall submit the annual fee, areport-and map showing the extent of 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 upc~~ming year, reclamation that will be performed during the coming year, the dates for the <br />beginning 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 <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If Rio new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous year's map are necessary, then no new map is required, provided that the <br />Operator shall state. this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the 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: -3~Ea"C~ioon L'/~'J2~~ ~ ~12 / % ~ <br />Permittee Name: <br />Address: <br />l{it Carson County <br />]?.O. Box 160 <br />13urlington, CO 80807 <br />Phone Number: x;719) 346-8139 <br />Fax Number: j 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 it to this form along with your written report and map. Annual Report instructions are <br />enclosed. <br />.~ <br />Signature of Corporate ficer, Owner, or Designee <br />Date <br />M:IPERMIT~fASTERDOCUME]VTS~f-AF-04 <br />