Laserfiche WebLink
~~~~ i <br />h~~~ <br />v ANNiiAi. FF.F, and RF.PCIRT RF,OiTF.ST <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME; <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />~ Lincoln County <br />t% M-1978-072 <br />Brent Pit <br />May 24, 2006 <br />$281.00 (Due on or before your anniversary date) <br />Lincoln <br />'-~ MAY 0 21006 <br />i/Oiuieion at Minerals and Geelopy <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 <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.dyring_the_prepeding.year,_new distur_hances_thatare_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 ym.r revised written annaal re,~nrt and annual relyyrrf main, to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written <br />report. <br />Division records indicate the following pennittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Don Blake <br />Permittee Name: Lincoln County <br />Address: P.O. Box 34 <br />Hugo, CO 80821 <br />Phone Number: (719) 743-2337 <br />Fax Number: {719) 743-2815 <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 />Signature of Corporate Officer, Owner, or Designee <br />©~~ ~~ ^ 010 <br />Dale <br />M:~PERMITMASTERDOCUMENTSM-AF-04 <br />