Laserfiche WebLink
PERMITTEE NAME„ <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE: <br />ANNUAL FEE DUE: <br />COUNTY: <br />AP + QPIr <br />ANNUAL FEE and REPORT RE VEST <br />?Nick H. Gray <br />J/M-2005-012 <br />Gray Pit #2 <br />January 10, 2011 <br />$791.00 (Due on or before your anniversary date) <br />Montrose <br /> <br /> <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 feet a report and map showing the extent o_current_-disturb a?ces-to affected 1 nd <br />- _n _ e <br />rec"Iama ion accomp is a to a e an duri he 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 vour 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 vear's map are necessary, then no new may 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: Nick H. Gray <br />Permittee Name: <br />Address: <br />Phone Number: <br />Fax Number: <br />Nick H. Gray <br />:584 65.30 Rd. <br />Montrose, CO 81401 <br />(970) 249-9436 <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 />Lemsee -rv N.t,(, Cvo- r- <br />i re of Corporate Officer, Owner, or Designee V <br />11.3 i 201 1 <br />Date