Laserfiche WebLink
otc <br />ecs <br /> /?? ' P- <br />ANNUAL FEE <br /> and REPORT REQUEST <br />PERMITTEE NAME: C <br />t V 1 1008 <br /> gap <br />oun <br />y <br />PERMIT NO.: Z-1987-159 <br /> z zrc: e,- <br />OPERATION NAME: Guenzi S & G Pit <br />ANNIVERSARY DATE: December 28, 2008 <br />ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) <br />COUNTY: Logan <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 <br />-=operator-shall-submit-the annual-fee; a-report-and.map_showing_the extent-of_cur-rent_disturbances_to_affected_ <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming 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 no 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: Kris Pennington <br />Permittee Name: <br />Address: <br />Logan County <br />315 Main St., Ste. 2 <br />Sterling, CO 80751 <br />Phone Number: (970) 522-7879 <br />Fax Number: (970) 522-4018 <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or a h to this form along with your written report and map. Annual Report instructions are <br />enclosed' J <br />Si ature of Corporate fficer, Owner, or Designee <br />Date <br />M:\PERMIT MASTERDOCUMENTS\NI-AF-04