2009-10-26_REPORT - M2001054 - Laserfiche WebLink

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4?7 i- p r ANNUAL FEE and REPORT REOUEST 9 PERMITTEE NAME: Bridalveil Construction gab Imm PERMIT NO.: M-2001-054 OPERATION NAME: Bridalveil ? OCT 2 6 .ZQ09 ANNIVERSARY DATE: October 28, 2009 ng. V D and Safety ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) COUNTY: Ouray 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 di?g'C e m ear, rec a n a e e of rmea urmg a coming year, e dates or the egmning 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 man. If no new disturbances or reclamation have occurred durine 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 suffice for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Emery L. Olin Permittee Name: Bridalveil Construction Address: 1796 N. Main St. P.O. Box 1412 Ouray, CO 81427. _ Phone Number: (970) 325-4674 Fax Number: If you have additional comments and/or information that should be provided to the Division, please provide it below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. gngnatur Corporate Officer, Owner, or Designee I Z2 ?Z Date/