2010-07-28_REPORT - M2004037 - Laserfiche WebLink

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(SAN A REQUEST PERMITTEE NAME: E-john M. Everitt RECEIVE JUL 2 8 2010 Division of Recla Mining & Sa ti°n, ,ty PERMIT NO.: • /-2004-037 OPERATION NAME: Everitt Pit ANNIVERSARY DATE: August 3, 2010 ANNUAL FEE DUE: $$323.00 (Due on or before your anniversary date) COUNTY: Phillips 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, _ 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 ring the coming year, the dates Tor 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 vear's map are necessary, then no new map is required, 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: John M. Everitt Permittee Name: John M. Everitt Address: 24274 CR 17 Haxtun, CO 80731 Phone Number: (970) 774-7508 ; 24Z2 Fax Number: If you have additional comments and/or information that should be provided to the Division, please provide it below or attach i o this form along with your written report and map. Annual Report instructions are enclosed. Si u'rre/j of Corporate Officer, Owner, or Designee Date