REP07502

• Permit No: M1977094
• IBM Index Class Name: Report
• Doc Date: 12/26/2003
• Doc Name: Annual Fee/Report Notice
• From: Morgan Sand and Gravel
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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R~~IE9VE®
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Morgan Sand and Gravel
M-1977-094
Westhoff Pit
December 20, 2003
DEC 2 S 2003
Division of Minerals and Geology
$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
---sha a a wing-[he-extent"of-cutTen o a ec ed-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 ^nur revised written anneal rennrt and anneal rcnnrt m~ 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:
Permittee Contact: Gary Westhoff
Permittee Name: Morgan Sand and Gravel
Address: P. O. Box 1443
Ft Morgan, CO 80701
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.
Si re of orate Office , Ow , o esignee
X2-17- 0 ~
Date
M:~PERM nVMASTERDOCUM ENTSVN-A F-01