2007-10-01_REPORT - M1980205

• Permit No: M1980205
• IBM Index Class Name: Report
• Doc Date: 10/1/2007
• Doc Name: Annual Fee/Report/Map
• From: Select Materials
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
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PERMITTEE NAME: Select Materials

PERMIT NO.: M-1980-205
OPERATION NAME: Select Materials
ANNIVERSARY DATE: October 2, 2007
ANNUAL FEE DUE: $$791.00 (Due on or before your anniversary date)
COUNTY: Weld
RECEIVED /
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Division of Reclamation. "Ij
Mining end SetetY ~/
_Accottling to.C.R.S_34.32.5~1.1.G_nr_C.R.S_34,3211CzYeach.v~ar, on th~.anniv~xsar~date of the_germit, an_o~ator ~
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 vour revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
man. If no new disturbances or reclamation have occurred during the previous vear and no new chances to
the previous year's map are necessary, then no new map is required. provided that the Operator shall state
this in the Annual Report. Please note that an adequately labeled map that clearly delineates and includes the
above elements may sufface for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact; Robert D. Oman
Permittee Name:
Address:
Select Materia]s
P.O. Box 280
Fort Lupton, CO 80621
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 inst''ru//ctionffs__aze enclosed.
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