2006-10-10_REPORT - M1999062 - Laserfiche WebLink

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~.sc PERMTTTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: ~/ ANNUAL FEE and REPORT REQUEST v Hector Rodriquez r/ M-1999-062 Indio Red Quarry Number I & 2 August 23, 2006 nv iS~L ib~~3 -off ~~~~ a!~'~I(~ /gyp/~OCT 10 2006 VMin~ng and Safety n, $281.00 (Due on or before your anniversary date) Larimer 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 shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, -- - -reclamation-accomplished to date-and-during-the-preceding-year,-pew-disturbances-that are-,anticipated-to-occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning of active operations, and the date active operations ceased for the year, if any. Please attach your revised written annual report and annual report map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated mau (All are required regardless of the level of disturbance or absence of disturbance during the previous year). Please note that an adequately labeled map that clearly delineates and includes the above elements may since for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Pennittee Contact: Abe Vasquez Permittee Name: Hector Rodriquez Address: P.O. Box 122 Phone Number: Fax Number: Lyons, CO 80540 (303)823-6116 (303)823-6888 If you have additional comments and/or information that should be provided to the Division, please provide it below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. i~ Signature of Corporate Officer, Owner, or Designee ~~ _/o -~~ Date