2011-03-22_REPORT - M2003021 - Laserfiche WebLink

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-7- 117--- AMOAL FEf and PORT REOUEST PERMITTEE NAME: ,Ranch Land LLC dba Pioneer Sand Co Inc PERMIT NO.: ` 141't--2003-021 OPERATION NAME: Ranch Land Rock Pit #2 ANNIVERSARY DATE: March 22, 2011 ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date) COUNTY: Fremont ok,e bM14_, F ' 71VED "1AR 2 2 2011 Divisjoi, 4 .'eu nation, Mining and Safety 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 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 man are necessarv, 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 since for a written report. Division records indicate the following permittee contact information. Please verify and make any necessary changes: Permittee Contact: William Peetz Permittee Name: Ranch Land LLC dba Pioneer Sand Co Inc Address: P.O. Box 7650 Colorado Springs, CO 80933 Phone Number: (719) 492-0266 Fax Number: (719) 473-5494 If you have additional comments and/or information that should be below or attach it to th' along with your written report and map. Signature of Corporate Officer, Owner, or Designee 3 z/A Date provided to the Division, please provide it Annual Report instructions are enclosed.