Laserfiche WebLink
ANNUAL FEE and REPORT REOUE,S?T/ <br />PERMITTEE NAME: Silver Mountain Pre erve, Inc. <br />PERMIT NO.: M-1992-003 MAR 2 0 2009 <br />OPERATION NAME: Willis Pit Division or Keclamation, <br />Mining and Safety <br />ANNIVERSARY DATE: February 7, 2009 <br />ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) <br />COUNTY: Huerfano <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-current-disturbanees-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 vour 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 may. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous vear'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: Travis R. Crawford <br />Permittee Name: Silver Mountain Preserve, Inc. <br />Address: 11850 CR 520 <br />v V d ! Js ??? e`© / <br />LL r .J <br />La Veta, CO 81055 <br />Phone Number: (719) 742-3971 <br />Fax Number: (719) 868-2416 <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 />Signature of Corporate Officer or wner <br />,=3- - / -/--o 55, <br />Date