Laserfiche WebLink
PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <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 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 />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: Jim Helmericks <br />Permittee Name: Glacier Gravel Products <br />Address: 995 Hwy 3 <br />Durango, CO 81301 <br />Phone Number: (970) 259 -3995 <br />Fax Number: (970) 375 -7880 <br />f\C 9,Y <br />ANNUAL FEE and REPORT REQUEST <br />ti <br />Glacier Gravel Products <br />M- 1985 -001 <br />J & J Pit <br />June 27, 2011 <br />$323.00 (Due on or before your anniversary date) <br />La Plata <br />If you have additional comments and/or information that should b, <br />below or attach it to this form along with your written report and <br />kik/ - og- (L <br />Signature of Corporate Officer, Owner, or Designee <br />Date <br />RECEIVED <br />-"JUN 2 2Z0,11 <br />Division of Reclamation, <br />Mining & Safety <br />provided to the Division, please provide it <br />ap. Annual Report instructions are enclosed. <br />KY() Ioe110 p6r0� <br />