2005-11-14_REPORT - M1977057

• Permit No: M1977057
• IBM Index Class Name: Report
• Doc Date: 11/14/2005
• Doc Name: Annual Fee/Report/Map
• From: Pioneer Sand Company Inc
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
A,N~N/i11Ai. FF.F. and RF.PnRT RF.QiTF,CT
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P}~neer Sand Company, Inc.
T /M-1977-057
Fedinec Pit
November 22, 2005

^'~~isic.. c ~ i .. ..'. , ,
$281.00 (Due on or before your anniversary date)
Moffat
---Aeeerding-to-C-R:&-34-32-5-1-ifi-o~GRa. ~^~! 6rea¢h-yearron_the.anniversary-date_of_the_peunit,.an operator
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach vrnnr revised written annnal re~nrt and anm~al re rpo t mgp to Chic form. please note that an
adequately Zabeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Joe Kraig
Permittee Name: Pioneer Sand Company, Inc.
Address: P.O. Box 7650
Colorado Springs, CO 80933
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
,/o A~,;~„y r.~,~,s P~.sT yam.
,$i~tatu~f Corpor e O tcer, Owner, or Designee
Date
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