2005-11-21_REPORT - M2000092

• Permit No: M2000092
• IBM Index Class Name: Report
• Doc Date: 11/21/2005
• Doc Name: Annual Fee/Report/Map
• From: City of Walsenburg
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
City of Walsenburg
2000-092
Walsenburg Gravel Pit
December 14, 2005
RECEIVED
~OV 2 t 2005
Division of Minerals and Geology
$281.00 (Due on or before your anniversary date)
Huerfano
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 y~r revised written annnal re~nrt and annnal re~nrt ma~tn 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 petmittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Matn•ice-Beau-~
Permittee Name: City of Walsenburg
Address: 525 S. Albert
Walsenburg, CO 81089
Phone Number: [phone]
Fax Number: [phone]
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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.
K~' " V l~
Si re orate Oft r, Owner, or esign
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Date
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