2010-10-05_REPORT - M2007003 - Laserfiche WebLink

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twl ANNUAL FEE and" REQUEST 0,L ;a PERMITTEE NAME: Yevoli Cobblestone Inc PERMIT NO.: ?/M-2007-003 OCT 0 5 2010 OPERATION NAME: Yevoli Cobblestone Pit Division oC?cclratrtio?, ANNIVERSARY DATE: September 6, 2010 ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) COUNTY: Fremont 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 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 ear's ma are necessary, then no new ma is re uired 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: Mark Yevoli Permittee Name: Yevoli Cobblestone Inc Address: 10001 Astoria Ct. Phone Number: Fax Number: If you have below or atf"h ?6ature of C,on f Lone Tree, CO 80124 (303) 912-1800 comments and/or information that should be provided to the Division, please provide it -oft along with your written report and map. Annual Report instructions are enclosed. It orate Officer, Owner, or Designee