REP00664

• Permit No: M1980149
• IBM Index Class Name: Report
• Doc Date: 2/20/2001
• Doc Name: SALES RECEIPT
• From: DMG
• To: WELD CNTY
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:

RECEIVED
FE9 2 0 2001
Division at Minerals and GEOlo9Y
$688.00 (Due on or before your anniversary date)
Weld
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 d~lriltg the upcoming year, reclamation that will be performed during [he 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 torn. Please note [hot an
adequately labeled rnap [ha[ clearly delineates and inchrdes [he above elemerr[s nrnv suffice jor n wrinerr
report.
• Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
PermitteeContact: Greg Nelson
Permittee Name: Weld County
Address: P.O. Box 758
IIII HSt.
Greeley, CO 80632
Phone Number: [phone]
Fax Number: [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.
Ignature Corporate Officer or Owner
~1,~.~oi
Date

Weld County
M-1980-149
Hokestra Pit No 1
March 1, 2001
ANNUAL FEE and REPORT REQUEST
M.~PERM IT~MASTERDOCUMENTSU1-AFAi