2001-10-29_REPORT - M1978168

• Permit No: M1978168
• IBM Index Class Name: Report
• Doc Date: 10/29/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST RECEIVED
PERMfITEE NAME: Delta County OCT 2 9 2001
PERMrF NO.: M-1978-168
Division of Minerals and Geology
OPERATION NAME: Pig Mesa Pit
ANNIVERSARY DATE: October 26,2001
ANNUAL. FEE DUE: $688.00(Due on or before your anniversary date)
COUN'.Y: Delta
Accord ng 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 dales for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. Please note that an
adegaa,ely labeled map that clearly delineates and includes the above elements may suffice j'or a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
change;:
Permittee Contact: 3@hn=T4ntb==
Permittee Name: Delta County
Address: 501 Palmer St., Ste. 227
Delta,CO 81416
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.
Si atE re of? orate Officer or Owner
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Date
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