Laserfiche WebLink
PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Permittee Contact: C-1 istephe 1. Var-ra ilfer h <br />Phone Number: (303)-666=665 7o 2 ci 3-1/yob <br />Fax Number: (303) 666 -6743 (17 2 S9Le/S <br />Date <br />ignature of' Corporate Officer, Owner, or Designee <br />6 - 20 -// <br />A._ R {' <br />)Varr A NNUA FEE and REPORT REOUEST <br />Companies Inc <br />/ M- 2001 -113 <br />Sea Horse Ranch West Gravel Pit <br />June 24, 2011 <br />$791.00 (Due on or before your anniversary date) <br />Gunnison <br />Frederick . J C 0 e'5 2 — <br />MIA <br />RECEIVED <br />JUN 2 2 Z®:ut <br />Divlsfon Re <br />Minin of & S afety <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 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 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 />man. 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 Name: Varra-Gempailies-inc Cow,p ties or 44es , <br />Address: &i-20-Gage -St_ 22 3 /e,-„e » / c / <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or . ch it to this form along with your written report and map. Annual Report instructions are enclosed. <br />