2007-09-13_REPORT - M1977301 - Laserfiche WebLink

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AF * RQT" ANNUAL FEE and REPORT REQUEST PERMITTEE NAME: Colorado Lien Company PERMIT NO.: M-1977-301 t/~ S~ 13~ ~~ OPERATION NAME: Roberts Quarry ANNIVERSARY DATE: September 22, 2007 ~~ ~rs~o., ~ _'_" ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) COUNTY: 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,_new 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 vour revised written annual report and annual report mao to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, reuort, and associated ma If no new disturbances or reclamation have occurred during the nrevious year and no new chanties to the previous year's map are necessary, then no new map is required, provided that the Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. Division records indicate the following permit[ee contact information. Please verify and make any necessary changes: Permittee Contact: Mitch Nachtigall Permittee Name: Colorado Lien Company Address: P.O. Box 440 Rapid City, SD 57709 Phone Number: (605) 342-7224 Fax Number: If you have additional comments and/or information that should be below or attach it to this form along with your written report and map. Signature o Corporate Officer, Owner, or Designee provided to the Division, please provide it Annual Report instructions are enclosed. Date