Laserfiche WebLink
.f <br />ANNUAL FE and )PORT REQUEST <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />At, ey J. Conner <br />Lee No 2 Placer <br />September 26, 2008 <br />Ar - 0, <br />R CE"'E <br />SEP 2 ?jk <br />Division of meuiairid <br />-7v Mining and Safety <br />$259.00 (Due on or before your anniversary date) <br />Gilpin <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 disturbanees-to affected-land; reclamation -- <br />accomplished to date and during the preceding year, new disturbances that are anticipated to occur during the <br />upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active <br />operations, and the date active operations ceased for the year, if any. <br />Please attach vour 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 map. <br />If no new disturbances or reclamation have occurred during the previous year and no new changes to the <br />previous year's map are necessary, then no new map is required provided that the Operator shall state this in <br />the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above <br />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: Thomas J. Musch <br />Permittee Name: Stanley J. Conner <br />Address: 19140 Co. Rd. 31.9 <br />Weston, CO 81091-9752 <br />Phone Number: (719) 868-3327 <br />Fax Number: <br />A icl-rr OPA Nt -, w <br />co <br />MA <br />If you have additional comments and/or information that should be provided to the Division, please provide it below <br />or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />M: \PERMIT1MASTERDOCUMENTS/M-AF-02.DOC