Laserfiche WebLink
<br />RECEP"~ `~D <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Mario Bassi and Josephine Bassi <br />M-2000-110 <br />North Farm Road Gravel Pit <br />September 17,2003 <br />$688.00 (Due on or before your anniversary date) <br />Rio Grande <br />SEP 0 g ~=:3 <br />Division ~1 MUtErals and Geology <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 lam, - <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 rennrt m ~n to this form- Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Mario Bassi <br />Permittee Name: Mario Bassi and Josephine Bassi <br />Address: 2000 N. Farm Rd. <br />Monte Vista, CO 81144 <br />Phone Number: (719) 852-3225 <br />Fax Number: <br />If you have additional comments and/or information that should be provided to the Division, please provide <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />~_ i~/.'~~s_2 . <br />Signature of Corporate Officer, Owner, or Designee <br />.~ •- 2 G ` r~ ~i <br />Date <br />M:~PERM ITU1ASTERDOCUMENTSUI-AF-01 <br />