2005-08-22_REPORT - M1995030

• Permit No: M1995030
• IBM Index Class Name: Report
• Doc Date: 8/22/2005
• Doc Name: Annual Fee/Report/Map
• From: Green Brothers Inc.
• To: DMG
• Media Type: D
• Archive: No

16-AUG-2005 10:37 FROt1-Colorado Division of Minerals i GealoQy [phone] T-346 P.002/002 ~~-73i
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PERMITCEE NAME: ~ G/r~n Brothers, Ina ~~~ v
PERMTf NO.: //1~I-1995-030 ~UG 2 2 2005
OPERATION NAME: Green Bros Pit No 2 ~ Division of Mii~, ... _ _
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ANNiVERSARXDATE: Jtt1y7,2005
ANNUAL FEE DUE: $281.00 (Due on or before your amnivetsary date)
COUNTY: Morgan
According to C.R.S. 34-32.5-116 or C.RS. 3432-116, each year, on the anniversary date of the permit ar. operator
shall submit the armual fee, a report and map showing the extent of current disturbances to affected land,
reclamatien accomplished to date and doting the preceding year, new disturbances that are antiripater to occur
during the upcoming year, reclamation that will be performed doting the corning year, the dates far the'ue~nnimg
of active operations, and the date active operations ceased for the year, if any.
Pleacp nMarh vnnr r.,vixvd written annnsl rrnnrt nd anmral r nrt ma~», to fhtc Fn~~_ PleasB tto'e that an
adequately labeled map Brat clearly delineates and includes the above elements may suJfrcefor a wrteten -eyo:•t.
Division records indicate the followit~ permittee contact information. Please vrrify and make any OeceGsary
charges:
Petmittee Contact: Tim F, Green
Permittee Nanre: Crrcen Brothers, Inc.
Address: 19441 U.S. Hwy. 34
P.O. Box 858
Ft Morgan, CO 80701
Phone Nmnber: [phone]
Fax Nmmber: [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 trap. Annual Report instructions are e:tclosed.
i azure of Corporate Officer, Ownet, or Dent
Date
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