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 and map showing the extent of current disturbances to affected land, reclamation <br />- accomplished to- date - and=during the-preceding-year, new disturbances that are- anticipated -to occur- during the <br />upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active <br />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 map. If <br />no new disturbances or reclamation have occurred during the previous year and no new changes to the previous ysear <br />map are necessary then no new map is required provided that the Operator shall state this in the Annual Report. <br />Please note that an adequately labeled map that clearly delineates and includes the above elements may suffice for a <br />written report. <br />Division records indicate the following permittee contact information Please verify and make any necessary <br />changes: <br />Permittee Contact: James MacDonald <br />Permittee Name: APC Southern Construction Co., LLC <br />James MacDonald <br />Address: 14802 W 44th Avenue <br />Golden, CO 80403 <br />Phone Number: 303 - 279 -6611 <br />Fax Number: 303 - 279 -6216 <br />If you have additional comments aonrd information that should be provided to the Division, please provide it below <br />or attach it to this form along with your written rep and map. Annual Report instructions are enclosed. <br />6 Qt-- V, P <br />Date <br />ANNUAL FEE and REPORT REQUEST <br />t rAPC Southern Construction Co., LLC <br />44-2000-118 <br />Pino Pit <br />November 15, 2011 <br />ure of Corporate Officer Owner or Designee <br />/ /a / <br />$ 791.00 (Due on or before your anniversary date) <br />Huerfano <br />frg- <br />NECEIVED <br />4r 91 2011 <br />�Q ivision of Reeianla, <br />' 7 U Mining & Safer <br />