Laserfiche WebLink
f <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />41k <br />j <br />ANN]a EE afid PORT REQUEST <br />Nielsons, Inc. <br />,,,M-1976-027 <br />Craig Pit <br />June 17, 2008 <br />RED A <br />MAY 2 1 2008 <br />--J)ivislun o, 11-;lainatlon, <br />Mining ana Safety <br />$$791.00 (Due on or before your anniversary date) <br />La Plata <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 annual 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 may 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 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: Craig Wickstrom <br />Permittee Name: Nielsons, Inc. <br />Address: P.O. Box 1660 <br />22419 CR G <br />Phone Number: <br />Fax Number: <br /> <br />Cortez, CO 81321 <br />(970) 565-8461 <br />(970) 565-0188 <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 />igna e of Corporate Officer, Owner, or Designee <br />Date