2011-04-14_REPORT - M2004025 - Laserfiche WebLink

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?? RC ( e.A'%i\VtiL rjv?L unu l\L' 1 V1\1 1\1:iV VL` 1.71 PERMITTEE NAME: ? Farnsworth Construction and Gravel Company PERMIT NO.: ,-?M-2004-025 IVY OPERATION NAME: North Fork Pit #/ APR 1 q 2011 ANNIVERSARY DATE: April 22, 2011 1 Division of Reclamation, ANNUAL FEE DUE: $323.00 (Due on or before your anniversary date) Mining & Safety COUNTY: Delta 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 corning 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 may to this form. The Annual Report & Fee requirement is not met until we have received the following components: fee, report, and associated 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: Patricia M. Farnsworth Permittee Name: Farnsworth Construction and Gravel Company Address: 175 Hwy 133 Phone Number: Fax Number: Paonia, CO 81428 (970) 527-4434 (970) 527-5522 If you have additional comments and/or information that should be provided to the Division, please provide it below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. -r ignature of Corporate icer, Owner, or Designee ee Ll- f- ll Date