Laserfiche WebLink
<br />PERMTITEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />City oCMonte Vista <br />M-1992-060 <br />Lagoon Pit <br />October 20, 2004 <br />RECEIVED <br />ocrta2oo~, <br />Division of Minerals and Ceolagy <br />$281.00 (Due on or before your anniversary date) <br />Rio Grande <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 during the preceding year, new disturbances that aze anticipated to <br />occur during the upcoming yeaz, reclamation that will be performed during the coming yeaz, the dates for the <br />beginning of active operations, and the date active operations ceased for the yeaz, if any. <br />Please attach your revised written annual report and annual rennrt map to this form. Please note that ars <br />adequately labeled map that clearly delineates and includes the above elements may since for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: \ t ' 1 \ ~ (((~~~ <br />Permittee Contact: 4jocig~{ark ~~~ ~~ ~ V ~lU "~ ~ Q, Q~ <br />Permittee Name: <br />Address: <br />City of Monte Vista <br />4 Chico Camino <br />Monte Vista, CO 81144 <br />Phone Number: (719) 852-2692 <br />Fax Number: (719) 852-6172 <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 />h ~VV~~ <br />Signature of Corporate Off cer, Owner, or Designee <br />Date <br />M:~PERMI7~MAS1'ERDOCIIMENTSM-AF-at <br />