2005-07-19_REPORT - M1983112

• Permit No: M1983112
• IBM Index Class Name: Report
• Doc Date: 7/19/2005
• Doc Name: Annual Fee/Report/Map
• From: kiowa county
• To: dmg
• Media Type: D
• Archive: No

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PERMTI"I'EE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Kiowa County
M-1983-112
Murdock Gravel Pit
August 25, 2005
JUL 19 2005
Dimsiwi u. t.. e,..,~as i t;e¢i¢gy
$281.00 (Due on or before your anniversary date)
Kiowa
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-sltall-submit-ihe-annual-fee,-a-reporhand-map-showing~the-extent-of current disturbances to affeoted-
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 attachwnur revised written annual rennrt and annnal re,Pnrt maP to this form- 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 permittee contact information. Please verify and make any necessary
changes:
PermitteeContact; ~FEiehard-R~fcDmtielRc4s~ed
Permittee Name:
Address:
Phone Number:
Fax Number:
Kiowa County
P.O. Box 100
Eads, CO 81036
[phone]
[phone]
ReuforeMUn- Allen W, LJaffS
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.
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Signa~e o Corporate Officer, Owner, or Designee
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Date
M:NERMITN-IASTERDOCUMENTSUI-AF-04