2007-04-18_REPORT - M1987020

• Permit No: M1987020
• IBM Index Class Name: Report
• Doc Date: 4/18/2007
• Doc Name: Annual Fee/Report/Map
• From: Rio Grande County
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANl~ ~ ~EE and REPORT REQUEST
PERMffTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
'~ Rio Grande County
/M-1987-020
374 Pit
Apri123, 2007
D""
APR 18 2007
~iaion of Reclamation,
Mining and Saf
~Y
$$688.00 (Due on or before your anniversary date)
Rio Grande
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 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 vour revised written annual report and annual report map to this form. The Annual
Report & Fee requirement is not met until we have received the following components: fee, report, and
associated map. If no new disturbances ar reclamation have occurred durinc the previous year and no
new chances to the previous year's map are necessary, then no new map is required, provided that the
Operator shall state this in the Annual Report. 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 perrnittee contact information. Please verify and make any necessary
changes:
Perrnittee Contact: Patrick Sullivan
Permittee Name: Rio Grartde County
Address: 168 N. Washington
Monte Vista, CO 81144
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 attach r to this form along with your written report and map. Annual Report instructions are
of Corporate Officer, Owner, or Designee
/~v r9/~.E p'7
Date
M:IPERMI'M1AS7ERDOC[1MENTSNI-AF-09