2009-05-08_REPORT - M1994096 - Laserfiche WebLink

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ANNUAL FEE and REPORT REQUEST PERMITTEE NAME: ?r^High Plains Sand and Gravel, LLC PERMIT NO.: ?1VI-1994-096 OPERATION NAME: Russell Gravel Pit -725-1 ANNIVERSARY DATE: April 14, 2009 ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) COUNTY: Larimer 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, - r cl_ama_t_um -acc m lished to-da and di r? iag the preceding year, new disturbances that are anticipated to occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning 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 chanEes 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: Robert Pittington Jr. Permittee Name: Address Phone Number: Fax Number: If you have additio below or attach it to High Plains Sand and Gravel, LLC P.O. Box 1228 Wellington, CO 80549 (970) 310-0987 (970) 568-9229 comments and/or information that should be provided to the Division, please provide it forralong with your written report and map. Annual Report instructions are enclosed. Signature of Corpora/tee bfficef,'Owner, or Designee C? Date