2004-06-22_REPORT - M2002068

• Permit No: M2002068
• IBM Index Class Name: Report
• Doc Date: 6/22/2004
• Doc Name: Annual Fee/Report/Map
• From: Rick Ensminger
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Rick Ensminger
M-2002-068
Ensminger Pit
July 29, 2004
$281.00 (Due on or before your anniversary date)
Phillips
~~
RECEdilE~
JUN 2 2 2004
Oivisian of Min6Fei~. d- sigpi~~`)
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-1 I6, each year, on the anniversary date of the permit, an operator
shall submit the annual fee, a report and m~ 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 ynnr revised written annual rennrt and annual rennrt man 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: Rick Ensminger
Permittee Name: Rick Ensminger
Address: 3500 Hwy. 6
Box 276
Haxtun, CO 80731
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.
Signature o~ orporate Officer, O er, or Designee
~o - ~ g-'OQ--
Date