2008-01-24_REPORT - M2000059 - Laserfiche WebLink

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~ ~j AL FEE and RE ORT REQUEST PERMTTTEE NAME: /Geroux Gravel ~ "' °~` PERMIT NO.: ~M-2000-059 / . ,. „ OPERATION NAME: Geroux Gravel ? ANNIVERSARY DATE: ~ February 22, 2008 ~ ~' '"~ ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) COUNTY: Custer 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, reclamatior. accomplished -to date and clurin¢- the nr~ceding-y~atYnPw ri;~t~~rhanceS,~hat are an ;ein~tec3 to -2c~ _ 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. If no new disturbances or reclamation have occurred during the previous year and no new changes to the previous year's map are necessary, then no new map is reauired, provided that the Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: Darrell Geroux Permittee Name: Geroux Gravel Address: 1100 CR 160 Westcliffe, CO 81252 Phone Number: (719) 783-2709 Fax Number: (719) 783-2709 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. Signature of Corporate fficer, er, or Designee Date