2003-06-26_REPORT - M1978162

• Permit No: M1978162
• IBM Index Class Name: Report
• Doc Date: 6/26/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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RECEIVE®
JUN 2 62003
Division of Minerals and Geology
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Morgan County
M-1978-162
Harvey Green Pit
June 29, 2003
$688.00 (Due on or before your anniversary date)
Morgan
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, reclamationon accomplis ed t- tl~- o 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 attach your revised written annual rennrt and annual rennrt ma,~n to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice jor a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Joe B. Baltazar
Permittee Name: Morgan County
Address: 17303 CR S
Ft Morgan, CO 80701
-P-hone.Number --[phone]--
Fax Number: [phone]
[phone]
[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.
~Kignature of Cdrporate Of~r, Ow/her, or Designee
~r/a~5`/03
Dale 1
M:~PERMITVv1ASTERD000M ENTSNI-A r-aa