2015-01-21_REPORT - M1981279

• Permit No: M1981279
• IBM Index Class Name: REPORT
• Doc Date: 1/21/2015
• Doc Name: Annual Fee/Report/Map
• From: Lex Nichols
• To: DRMS
• Email Name: AME
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Otero County (Engineering)
M- 1981 -279
Hancock Gravel Pit
February 1, 2015
'RECEIVED
JAN 21 2015
INVISION OF RECLAMATION
MINING AND SAFETY
5791.00 (Due on or before your anniversary date)
Otero
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 disturbance or reclamation have occurred during the previous year
and no new changes to the previous year'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 perm tee contact information. Please verify and make any
necessary changes:
Permittee Contact: Lex Nichols
Permittee Name: Otero County
Address: 13 West 3`d Street, Suite 208
La Junta, CO 81050
Phone Number: (719) 383 -3035
Fax Number (719) 383 -3935
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.
Signa ure o Corporate office, Owner, Or Designee
to
M: \PERMIT/MASTERDOCUMENTS\M -AF -04