2007-06-21_REPORT - M2001033 - Laserfiche WebLink

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j~~l ~; ANNUAL FEE and REPORT REQUEST PERMITTEE NAME: Rough Cut, LLC R~cEi 1 0~~ ` PERMIT NO.: ~'I-2001-033 (/~t Z 1 V GJ OPERATION NAME: Rough Cut Pit ~rvl,~on o, 2~~7 ANNIVERSARY DATE: July 17, 2007 / i~ anc ~~, ANNUAL FEE DUE: $$688.00 (Due on or before your anniversary date) COUNTY: Otero f~ 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 map to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated ma . If no new disturbances or reclamation have occurred during the previous year and no new chances to the previous year's map are necessary, then no new man 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 since for a rovritten report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Alan Frantz Permittee Name: Address: Rough Cut, LLC 15645 Rd. GG Rocky Ford, CO 81067 Phone Number: (719) 254-4576 Fax Number: 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 instrucfions are enclosed. ~C~[fRg.~~-l F Signature o porate Officer, or Designee ~~ ~ 1 g~ m Date