Laserfiche WebLink
d? <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />December 18, 2010 <br />.j lC <br />iV ED <br />V`'z'; J <br />Divisi-on of r e; z, -latlon, <br />$323.00 (Due on or before your anniversary date) <br />Huerfano <br />According to C.Z.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary-date of-the-permit, an- <br />operator shall submit the annual fee, a report and map showing the extent of current disturbances to affected <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning 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 map to this form. The Annual <br />Report & Fee requirement is not met until we have received the following components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred during the previous year and no <br />new changes to the previous year's may are necessary, then no new map is required, provided that the <br />Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the 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: Bill Brunelli <br />Permittee Name: Huerfano County <br />Address: 401 Main St., Ste. 105 <br />Walsenburg, CO 81089 <br />Phone Number: (719) 738-2420 <br />Fax Number: (719) 738-3996 <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 <br />enclosed. <br />Signa of Corp ate Officer, Owner, or Designee <br />r ? •- f '7 ? l'c? <br />Date <br />ANNUAL EE and REPORT REOUEST <br />rfano County <br />22001-106 <br />Orlando Pit <br />M: \PERMIT\MAS TERDOCUMENTS\M-AF-04