Laserfiche WebLink
<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />,~~ ~. RPr <br />ANNUAL FEE and REPORT REQUEST <br />Sedgwick County <br />M-1996-073 <br />Dolezal Gravel Pit <br />November S, 2007 <br />RECEIVED <br />NOV 0 7 2007 '~ <br />Division of Reclamation, <br />Mining and Safety <br />$$323.00 (Due on or before your anniversary date) <br />Sedgwick <br />_~a,j, cord~ng to C.R~S..34-32.5-11_6 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an <br />operator shall submit the ann a fee, a reporrt an-and ma' p sF'iow'mg`the exrent-af'current disturbances-to affected- _ <br />land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to <br />occur during the upcoming year, reclamation that will be performed during the coming year, the dates for the <br />beginning of active operations, and the date active operations ceased for the year, if any. <br />Please attach vour revised written annual report and annual report maa to this form. The Annual <br />Report & Fee requirement is not met until we have received the follbtVing components: fee, report, and <br />associated map. If no new disturbances or reclamation have occurred durinti the arevious vear and no <br />new chanties to the brevious year's mab are necessary, then no new maq is required, nrovided that the <br />Operator shall state this in the Aunual Report. Please note that an adequately labeled map that clearly <br />delineates and includes the above elements may since for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Randy Renquist <br />Permittee Name: Sedgwick County <br />Address: 223 S Cedar <br />Julesburg, CO 80737 <br />Phone Number: (970) 474-3576 <br />Fax Number: (970) 474-3558 <br />If you have additional comments and/or information that should be~rovided 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 />Signatur~~e of Corp ate r, ner, or Designee <br />~- ~g-~ <br />Date <br />M:~PERMINIASTEADOCUMENTS~M-AF-04 <br />