2003-09-11_REPORT - M1998065

• Permit No: M1998065
• IBM Index Class Name: Report
• Doc Date: 9/11/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

' _,:
Washington County
M-1998-065
Hayes Pit
September 18, 2003
FifCEiVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME;
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:

SEP 1 1 2003
Division of fvlinerals and Geologq
$281.00 (Due on or before your anniversary date)
Washington
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 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 anneal rennrt and anneal re urt mate to this fnrm_ 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 infotmation. Please verify and make any necessary
changes:
Permittee Contact: Charles J. Kuntz
Permittee Name: Washington County
Address: 150 Ash
Akron, CO 80720
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 form along with your written report and map. Annual Report instructions are
enclosed.
Signature of Corpo ate Officer weer, or Designee
~-~6-03
Date
M iPERM1TVNASTEftD000MENTSVN-AF-00