Laserfiche WebLink
P c~~v,~.. Q~~-e~k <br />ANNUAL FEE and REPORT REQUEST <br />PERMITTEE NAME: Everist Materials, LLC ~ <br />PERMIT NO.: M-1998-052 <br />OPERATION NAME: Mascot Placer <br />ANNNERSARY DATE: July 22, 2008 <br />ANNUAL FEE DUE: $791.00 (Due on or before your anniversary date) <br />COUNTY: Summit <br />[~ ~'~[~~~I~D <br />~JUL ~ :~ 2008 t/ <br />Division of ~eCiarnation,~ <br />RNining and Safety <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 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. The Annual Report <br />& Fee requirement is not met until we have received the following components: fee, report, and associated <br />man. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's man are necessary, then no new map is required. provided that the Operator shall state <br />this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the <br />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: Eric Blaylock <br />Permittee Name: Everist Materials, LLC <br />Address: P.O. Box 1150 <br />Silverthorne, CO 80498 <br />Phone Number: (970) 468-2521 <br />Fax Number: (970) 468-2756 <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 />%~ <br />Signature of Corporate Of cer, Owner, or Designee <br />~ ~'- a/ -tea' <br />Date <br />~ _ .~ <br />JUN ~ ~ 20~ <br />