2009-06-10_REPORT - M2007030

• Permit No: M2007030
• IBM Index Class Name: REPORT
• Doc Date: 6/10/2009
• Doc Name: Annual Fee/Report/Map
• From: City of Rifle
• To: DRMS
• Permit Index Doc Type: Annual Fee/Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
City of Rifle V
M-2007-030 ~/
City of Rifle Material Resource Area
June 13, 2009
~~~?~
JUN 10 2009
Di~aion of F~ecL:matia~,
AAining and Safety
$323.00 (Due on or before your anniversary date)
Garfield
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, reclamation accomplished to date and during 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 durin the previous year and no
new changes 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 since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Bill Sappington
Permittee Name: City of Rifle
Address: Public Works Director
~oc~ t•~c lL C . {-~arn i l-~-o N
202 Railroad Avenue
Rifle, CO 81650
Phone Number:
Fax Number:
[phone]
[phone]
If you have additional comments and/or}'
below or attach it to this form alon Jv
~ . ~ ,/ / /
G ~
Signature of Corporate Officer, per, or esigne~
~0 7 Z~
Date
n that should be provided to the Division, please provide it
written report and map. Annual Report instructions are
M: ~PERMITIMASTERDOCUMENTSUvI-AF-04