2006-05-19_REPORT - M1979103

• Permit No: M1979103
• IBM Index Class Name: Report
• Doc Date: 5/19/2006
• Doc Name: Annual Fee/Report/Map
• From: Diana K. Watson
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

SSG
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNTiAi, FF.F. and RF,Pt7RT RF.Oi1FST
,Diana K. Watson
t/ M-1979-103
Amick Pit
Apri18, 2006
~`~CEIVED
MAl` t 9 ?OQ6
r/Division of Minaala and Geology
$281,00 (Due on or before your anniversary date)
Rio Blanco
~h~a~--
According to C.R.S..-34-32.5-1-16 or C.R.S. 34-32-L16; 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,-recl'amatiori thaYwiii-be perftirmed 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 ynnr revised written annnai repo and anm~al re~nrt maT to this form- Please note that an
adequately labeled map 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: Diana K. Watson
Permittee Name: Diana K. Watson Pp GCar 5'a n~ v ~ian~ I SMG
Address: 840 CR# 4 .3a ~ / iQRC #y
P.o. sox los6 P. ~ BaX /sso
Meeker, CO 81641 ~~o`~/~ ~O R'//,~f/
Phone Number: [phone] 9 ~o -5378 -,-'36 7 /' - ` ' `~
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 form along with your written report and map. Annual Report instructions are enclosed.
Signature of Corporate Officer, Owner, or Designee
s/
~~rs`/o 6
Date