2006-03-08_REPORT - M1998034

• Permit No: M1998034
• IBM Index Class Name: Report
• Doc Date: 3/8/2006
• Doc Name: Annual Fee/Report/Map
• From: Mountain Park Concrete Inc.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

i
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
e.b vn
~/ ANNiiAi, FEF, and RF.PnRT RF.niTFST
t/ Mountain Park Concrete, Inc.
t/~M-1998-034
Parshal Pit
March 17, 2006
RECEIVED
MAR 0 0 2006
`~DmaiOn of Minerals and Geology
$281.00 (Due on or before your anniversary date)
Grand
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 aitaeh ym~r revised written anneal rennrt and anm.al re n~ rt main fn this form- 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 permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: M. Joe Docheff, III
Pettnittee Name: Mountain Park Concrete, Inc.
Address: P.O. Box 856
Granby, CO 80446
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.
i a~a •e of lor~ate~Of , , weer, or Designee
~~ ~~ !~
Date