2001-07-18_REPORT - M1992051

• Permit No: M1992051
• IBM Index Class Name: Report
• Doc Date: 7/18/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

IIIIIIIIIIIIIIIIIII •
ANNUAL FEE and REPORT REQUEST RECEIVED
PERMITTEE NAME: Florence Sand & Gravel JUL 18 2001
PERMIT NO.: M-1992-051 Olvision er Minerals and Geology
OPERATION NAME: Florence Sand & Gravel Pit
ANNIVERSARY DATE: August 11,2001
ANNUAL FEE DUE: $688.00(Due on or before your anniversary date)
COUNTY: Fremont
According to C.R.S. 34-32.5-1 16 or C.R.S. 34-32-1 16,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, 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 report and annual report map 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: Del Rodarmel
Permittee Name: Florence Sand & Gravel
Address: 799 5th St.
Penrose, CO 81240
Phone Number: [phone]
Fax Number:
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 Corp rate Officer or Owner
:21
Date
A1:WERMnw1ASTERD000MENTSNb AF 01