2006-08-07_REPORT - M1998038 - Laserfiche WebLink

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~R PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNNERSARY DATE: ANNUAL FEE DUE: COUNTY: ~rn 1~= Y ANNUAL FEE and REPORT REQUEST Kirkland Construction, RLLP /M-1998-038 Two Rivers ~~~~~~~® ,~ ~AUG ~ 7 ZUtl6 Urvisioa of Minerals and GeolopY August 3, 2006 $685.00 (Due on or before your anniversary date) Pueblo 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 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 map (All are required regardless of the level of disturbance or absence of disturbance during the previous year). Please note [hat an adequately labeled map that clearly delineates and includes the above elements may suffice far a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Joe C. Baxter Permittee Name: Kirkland Construction, RLLP Address: Phone Number: Fax Number: 2101 Main St. P.O. Box 580 Rye, CO 81069 (719) 489-3385 (719) 489-2265 If you have additional comments and/or information that should be provided to the Division, please provide it mow or attach it to this form along with your written report and map. Annual Report instructions are enclosed. Sigrtatur of~rpo/rate Officer, Owner, or Designee Date