Laserfiche WebLink
~j <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />s ~' <br />EE a~~)~PORT RE VEST <br />Ricky W. Mitchell <br />~ M-1987-023 <br />Mitchell Pit <br />March 31, 2008 <br />$$323.00 (Due on or before your anniversary date) <br />Adams <br />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 <br />shall submit the annu~~l 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 surf ce for a written report. <br />Division records indic~~te the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Ricky W. Mitchell <br />Permittee Name <br />Address: <br />Ricky W. Mitchell <br />P.O. Box 10 <br />Bennett, CO 80102 <br />Phone Number: (303) 644-4102 <br />Fax Number: <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 />/, ~ ~r~ , <br />Signature of C orate Officer, Owner, or Designee <br />RECEIVED <br />1~ <br />Date 'F1AR 31 2008 <br />piuision or rteGamati~, <br />Mining and Safet'I <br />