Laserfiche WebLink
PERMITTEE NAME: <br /> <br />PERMIT NO.: // <br />-M-2000-046 <br />OPERATION NAME: Phillips Ranch Property Gravel Pit #2 <br />ANNIVERSARY DATE: June 16, 2009 <br />k4k <br />Iili? O D <br />SUN '112609 <br />DWbim of Fdeclarnsi0n, <br />TNiaing and Safety <br />ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) <br />COUNTY: Fremont <br />O r--- <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 year2 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 />map. If no new disturbances or reclamation have occurred during the previous year and no new changes to <br />the previous year's map 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 suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Mike Ausbum <br />Permittee Name: Pioneer Sand Company Inc <br />Address: P.O. Box 7650 <br />_ Colorado Springs, CO 80933 <br />Phone Number: (719) 599-8100 <br />Fax Number: (719) 599-5317 <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 th' orm along with your written report and map. Annual Report instructions are enclosed. <br />Signature of rporate Officer, Owner, or Designee <br />/l /': ^ <br />ANNUAL FEE and PORT REQUEST <br />v''Pioneer Sand Company Inc <br />le/9/d"?' <br />Date