2006-10-10_REPORT - M1999064 - Laserfiche WebLink

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io /3 -ok~ ~-- PERMITTEE NAME: PERMIT NO.: OPERATION NAME: ANNIVERSARY DATE: ANNUAL FEE DUE: COUNTY: ANNUAL FEE and REPORT REQUEST ~ /Luis M. Vasquez f M-1999-064 Lyon King Quarry August 23, 2006 ~:~'~' ~' ~ 91f~ ~ ~'~" OCT 10 2006 r~ivision of Reclamation, Mining and Safety $281.00 (Due on or before your anniversary date) Latimer 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 annuat-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, acid 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 that an adequately labeled map that clearly delineates and includes the above elements may since far a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Permittee Name: Address: Abe Vasquez Luis M. Vasquez P.O. Box 122 Lyons, CO 80540 Phone Number: (303) 823-6116 Fax Number: (303) 823-6888 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 instructions are enclosed. Si Corporate Officer, Owner, or Designee l(J-lO-~C Date