Laserfiche WebLink
'Ao ~5~s~ <br />.._ <br />RECEIVED <br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />Las Animas County <br />M-1979-163 <br />Shannon Pit <br />September 27, 2003 <br />SEP 2 22003 <br />Division ~f Minerals and Geology <br />$281.00 (Due on or before your anniversary date) <br />Las Animas <br />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 <br />operator-shall- submit-the-annual- fee,- a-report-and -map-showing-the-extent-occurrent-disturb :nces-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 your revised written annnal rePnrtand annnal report m,n to this form- please note that an <br />adequately labeled map that clearly delineates axd includes the above elements may suffice for a written <br />report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Phil Dorenkamp <br />Permittee Name: Las Animas County <br />Address: 2000 N. Linden Ave. <br />Trinidad, CO 81082 <br />Phone Number: 48 7 / rJ ~(~ ~.~/ <br />' Fax Number: (71 6-7160 ~/ ~ ~'~~( d~„~ <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 <br />Owner, or Designee <br />Date <br />M:~PERMITMASTER DOCUMENTSVN-AF-04 <br />