2005-06-22_REPORT - M2003021

• Permit No: M2003021
• IBM Index Class Name: Report
• Doc Date: 6/22/2005
• Doc Name: Annual Fee/Report/Map
• From: ranch land llc
• To: dmg
• Media Type: D
• Archive: No

PERMTITEE NAME:
PERMiT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Raneh Land LLC
M-20Q'i-021
Rash Land Rock Pit #i2
Mareh 22, 2005
RECEIVED
MAR 2~2 2~5
Dhridos sf Minerals eM tisalopy
x688.00 (Doe on or before your anniversary date)
Fremont
According to C.R.S. 34-325-116 or C1LS. 34-32-1 l6, each year, on the annversary date of the petnu; an operator
sha11 submit the srmual fee, a report and map showing the extent of current disbrbances to affected laml,
reclamation accomplished bo date and during the precedimg.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.
PIrASn aftweh ^nr revised en snne~r~ ort wnd anaegl rennrt ma~rn /Ma lnmt Please rtOt¢ plat an
adequately labeled map that clemly delineates and includes the above elements may su,Q"uefor a written report.
Division records indicate the following perarittee cordact information. Please verify and make any necessary
changes:
Permittee Contact: William Peetz
Per~ttee Name: Ranch Land LLC
Address: 3925 Hill Circle
Colorado Springs, CO 80904
Phone Number: [phone]
Fax Number: [phone]
If you have additional rnnurrenffi and/or infornmtion that should be provided to the Division. Please provide it
below or attach it to ihjsfprm along with your written report and nmp. Amual Report insbirctions are enclosed.
Sigmature rporate officer, owner, or ~ ee
3~i/~o 5-
Date