2004-10-15_REPORT - M1978287

• Permit No: M1978287
• IBM Index Class Name: Report
• Doc Date: 10/15/2004
• Doc Name: Annual Fee/Report/Map
• From: Valco Gunnison Concrete Division
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMTI'TEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
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Valco Gunnison Concrete Division
M-1978-287
Vader Pit
October 5, 2004
FBEC~NC~ -.~
ocr ~ 5 2ooa
Divisloa of Mioe,~ilv & 0vvl®!V
$688.00 (Due on or before your anniversary date)
Gunnison
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-aad-dnriag_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 yonr revised written annnal rennrt and annnal rennrt m~ to this form- Please note that an
adequately labeled Wrap 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:
Permittee Contact: Ed Stewart
Permittee Name: Valco Gunnison Concrete Division
Address: P.O. Box 837
Gunnison, CO 81230
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 or attach it to this forth along with your written report and map. Annual Report instructions are enclosed.
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Signature of Corporate Officer, Owner, or Designee
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