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2010-09-24_REPORT - M1980205
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2010-09-24_REPORT - M1980205
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Entry Properties
Last modified
8/20/2019 10:29:21 AM
Creation date
9/27/2010 9:06:42 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1980205
IBM Index Class Name
REPORT
Doc Date
9/24/2010
Doc Name
Annual Fee/Report/Map
From
Select Materials
To
DRMS
Permit Index Doc Type
Annual Fee/Report
Media Type
D
Archive
No
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<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />i <br />ell EE and REPORT REOUEST <br />10XSe ect Materials <br />,?/-1980-205 <br />Select Materials <br />October 2, 2010 <br />$$791.00 (Due on or before your anniversary date) <br />Weld <br /> <br /> <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 fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomp iglred-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 vour revised written annual report and annual report map 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: Robert D. Oman <br />Permittee Name: Select Materials <br />Address: P.O. Box 280 <br />Fort Lupton, CO 80621 <br />Phone Number: (303) 857-4688 <br />Fax Number: (303) 857-4638 <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 />ZL <br />? OL--? <br />Signature of Corporate Officer, Owner, or Designee <br />g11?2/0 <br />Date
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