2008-09-26_REPORT - M2003052 - Laserfiche WebLink

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)Plu ANNUAL FEE REPORT REOUEST k PERMITTEE NAME: carder Inc PERMIT NO.: , . /M-2003-052 OPERATION NAME: Windy Ridge Pit ANNIVERSARY DATE: September 2, 2008 ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) COUNTY: Prowers 140 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-corning-year,_the_dates for he_ bg nning_ _ 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 map. If no new disturbances or reclamation have occurred during the previous year and no new changes 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 suffice for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Ron Peterson Permittee Name: Address: Carder, Inc. P.O. Box 732 Lamar, CO 81052 Phone Number: (719) 336-3479 Fax Number: (719) 336-0196 If you have additional comments and/or information that should be provided to the Division, please provide it below or attach it to is form alon with your written report and map. Annual Report instructions are enclosed. ® A Signature otCorpora Off el, Owner, or Designee Date