REP00039

• Permit No: M1993087
• IBM Index Class Name: Report
• Doc Date: 2/3/2004
• Doc Name: 2004 Annual Report
• From: Baca County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Valco -Lamar Div
M-1977-223
Wiley Pit
February 7, 2004
REC~~ ~ :.~.
FHB 0 3 t'~{
OlYision of Minerals & CeoloBY
$688.00 (Due on or before your anniversary date)
Prowers
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
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 Ynnr revised written anneal remnrt and anmral re~nrt maw to this form- 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:
Permittee Name:
Wayne Adams
Valco -Lamar Div
Address: P. O. Box 591
Phone Number:
Fax Number:
Lamar, CO 81052
[phone]
[phone]
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.
Signatu a of Corporate Officer, Owner, or Designee
~- ~~ -
Date
M:IPERMI'I~MASTERDOCllMEMSVvI-AF-01