Laserfiche WebLink
lam' <br />ki= + p- ?-F <br />ANNUAL FEE and REPORT REOUEST <br />PERMITTEE NAME: -Elam Construction, Inc. AgC91V D <br />PERMIT NO.: ? M-1999-076 V AN a 9 2010 <br />OPERATION NAME: Highway 50 Borrow Area No. 2 Division of RgclamaUon, <br />ANNIVERSARY DATE: August 5, 2010 Mining & SafatY <br />ANNUAL FEE DUE: $504.00 (Due on or before your anniversary date) <br />COUNTY: Mesa <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--fe-e5 a-report-and-map-showing-the-<extent=of-current=disturbances-to-affected--land; - - <br />reclamation accomplished to date and during the preceding year, 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 man 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 map are necessary, then no new map 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: Stephen Kaspar <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Elam Construction, Inc. <br />556 Struthers Ave <br />Grand Junction, CO 81501-3826 <br />(970) 242-5370 <br />(970) 245-7716 <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 Corporate Of is , Owner, or Designee <br />'Z 0 /0 <br />Date