2001-12-20_REPORT - M1976009HR

• Permit No: M1976009HR
• IBM Index Class Name: Report
• Doc Date: 12/20/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
RI.CEIVEC~
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Schmidt Construction Company
M-1976-009-HR
Menzer Quarry
December 31, 2001
$685.00 (Due on or before your anniversary date)
EI Paso
DEC 2 0 2001
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Division of Minerals and Geology
According to C.R.S. 34-32.5-I 16 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 a.iticipated 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 resort map to this form. Please mote that an
arlegaare(y 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:
Permi[[ee Contact: Scott Davis
Permi[[ee Name: Schmid[ Construction Company
Address: 2635 Delta Dr.
Colorado Springs, CO 80910
Phone Number: [phone]
Fax Number:
If you have additional comments and/or information [hat 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.
Signature of Corporate Officer or Owner
~l as-©/
Date
M dPERA1 rfN1ASTERD000MENTSVd AF-01