2009-10-13_REPORT - M1977347 - Laserfiche WebLink

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a7- ANNUAL FEE and REPORT REQUEST PERMITTEE NAME: PH01cim (US) Inc. PERMIT NO.: q41-1977-347 V'OCT 13 2009 OPERATION NAME: Slab Canyon Quarry DIV.4 or hwcl oration, "t 0 Pining and Safety ANNIVERSARY DATE: October 10, 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, reclamation accomplished to date and during the preceding_y_ear,-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 map 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 changes to the previous vear's man are necessarv, then no new man is reauired, 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: Michael B. Toelle Permittee Name Address Holcim (US) Inc. 3500 Highway 120 Phone Number Fax Number: If you hay diti below or a c it I Florence, CO 81226 (719) 484-1402 (719) 784-3470 comments and/or information that should be provided to the Division, please provide it form along with your written report and map. Annual Report instructions are enclosed. Signature of Corporate Officer, Owner, or Designee Date