2009-12-24_REPORT - M2006047 - Laserfiche WebLink

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3 ANNUAILFEE an REPORT REQUEST WCNM �EC 2 4 2009 Division ©fRoa o�9, mining sw , 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 precedingiyear, 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 vour 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 changes to the previous vear's map are necessarv, 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: Carol Fritz Permittee Name: Kit Carson County Address: Chairman P.O. BOX 160 Burlington, CO 80807 Phone Number: (719) 346 -8139 Fax Number: (719) 346 -7242 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. Y ure of Corpo Officer, Owner, or Designee J of (LA [ C - ) , i. Date M:\PERMIT\MASTERDOCUMENTS\N4-AF-04 PERMITTEE NAME: Kit Carson County PERMIT NO.: /I- 2006 -047 OPERATION NAME: Klassen Pit ANNIVERSARY DATE: November 28, 2009 ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) COUNTY: Kit Carson WCNM �EC 2 4 2009 Division ©fRoa o�9, mining sw , 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 precedingiyear, 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 vour 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 changes to the previous vear's map are necessarv, 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: Carol Fritz Permittee Name: Kit Carson County Address: Chairman P.O. BOX 160 Burlington, CO 80807 Phone Number: (719) 346 -8139 Fax Number: (719) 346 -7242 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. Y ure of Corpo Officer, Owner, or Designee J of (LA [ C - ) , i. Date M:\PERMIT\MASTERDOCUMENTS\N4-AF-04