Laserfiche WebLink
i <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />,? P -4-- ITT 0--- <br />ANNUAL FEE and REPORT REQUEST <br />Oldcastle SW Group, Inc. .b.a. B & B Excavating <br />M-1986-104 <br />Montgomery Pit <br />May 24, 2009 <br />$791.00 (Due on or before your anniversary date) <br />Eagle <br />(;F-jN1 <br />CjpY 6 2009 <br />510 ivFe? of recm?, <br />Wj" and Safety <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 disturbances to affected land, <br />reclamation accompli-she-i-to-date-and-during the- precedingyear, new-disturbances-that-are-anticipated-to-occur- - <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />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 Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's may are necessary, then no new may is required, provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Jason Burkey <br />Permittee Name: Oldcastle SW Group, Inc. d.b.a. B & B Excavating <br />Oldcastle SW Group, Inc. <br />Address: Box 1 d h a B&B Excavating <br />P.O. Box 4870 <br />wards, CO 2 'age' CO 81631 <br />Phone Number: (970) e-3311 7C7 `3 2 17 39 <br />Fax Number: 1-70 329---' /73S <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 o orporate Offi er, Owner, or Designee <br />Date