REP07947

• Permit No: M1977407
• IBM Index Class Name: Report
• Doc Date: 12/21/2001
• Doc Name: MINED LAND RECLAMATION BOARD 112C ANNUAL FEE INVOICE AND REPORT REQUEST
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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(RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Montrose County
M-1977-407
Cedar Creek Pit
January 30, 2002
$688.00 (Due on or before your anniversary date)
Montrose
DEC 2 1 2001
Division of Minerals and Geology
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date r>f the permit, an
operator shall submit the annual fee, a report and map showing the extent of current disturb.3nces 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 maa to this form. Phrase note that art
adequately labeled rnap [hat clearly delineates acrd includes the above elements mny suffice for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
PerrnitteeContace Brian Wilson
Permittee Name: Montrose County
Address: 161 S. Townsend
Phone Number:
Fax Number:
Montrose, CO 81401
[phone]
[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.
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Signature of Corporate Officer or Owner
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