REP04111

• Permit No: M2000049
• IBM Index Class Name: Report
• Doc Date: 4/9/2002
• Doc Name: 2002 Annual Report
• From: Louisiana Land and Gravel Company LLC
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

i a
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
RECEIVED
ANNUAL FEE and REPORT REQUEST
Louisiana Laad and Gravel Company, LLC
M-2000.049
Angie Pit
April 9, 2002
APR 0 92002
Oivisian of Minerals and Geology
$688.00 (Due on or before your anniversary date)
Montrose
According to C.R.S. 34-32.5-i 16 or C.R.S. 34-32-116, each year, on the antversary date of the permit, an Operator
shall submit the annual fee, a report and toap showing the extent of current disttrbances to affected land,
reclamation-acCOrttplishcd to"dzte tired during-the preceding year, new disturbances that-tiro-anticipated to occur-
during the upcoming yeaz, reclamation that will be performed during the corning year, the dales for the beginning
o€ active operatitms, and the date active operations ceased for the year, if any.
Please attach vour revised written snnoal reuort and annual report mao to this form. Plerctc note that an
adequately labeled map chat clearly delineates and includes the above elements may since fnr a written repora.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Pe[mit[ee Contact: Michael A. DeJohn
Permittee Name: Louisiana Land and Gravel Company, LLC
Address: P.O. $ox 8419
Clinton, LA 70722
Phone Number: [phone]
Fax Number: [phone]
Signattue of Corporate Officer or Owner
~~$~o~
Date
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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.
Willigm5 ConsfYuc~7'on ConfracfarS
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