Laserfiche WebLink
iiiiiiiiiii <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />ANNUAL FEE and REPORT REQUEST <br />ELB Stone, Inc. <br />M-1981-107 <br />Buster Quarries <br />January 8, 2002 <br />RECEIVE® <br />JAN 2 5 2002 <br />Division of Minerals and Geology <br />$ti88.00 (Due on or before your anniversary date) <br />Latimer <br />~~~ <br />According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written annual report and annual report map to this form. P(errse note rlrnt an <br />adequately labeler! Wrap rlr~nt clenr/v rlelntear sands and i~ the above a ements nmy suffice for a mitten report. <br />Division recor iridicafe the owing permittee contac formation. Please verify an ake a necessary <br />changes: , <br />Permi[[ee Contact: David E. Buster <br />Permittee Name:. ELB Stone, Inc. <br />Address: P.O. Box 42 <br />Phone Number: <br />Fax Number: <br />Lyons, CO 05045 <br />(802)222-4540 <br />1802) 222-58.1 <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 enclosed. <br />i f <br />S~ig~n~tu of Corporate Officer or Owner <br />/~~UZ <br />Date <br />A7:WERAIrIN7ASTERDnCUA1ENTSNI-A F-01 <br />