2006-01-12_REPORT - M1978314

• Permit No: M1978314
• IBM Index Class Name: Report
• Doc Date: 1/12/2006
• Doc Name: Annual Fee/Report/Map
• From: King Mountain Gravel LLC
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~~ RECEIVEp
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNiiAi. FF,F and RF.Pl7RT RF.Oi1F.ST
t/
- /King Mountain Gravel, LLC
y M-1978-314
King Mountain Sand & Gravel Mine
November 22, 2005
~~ JAN 12 2~pS
"fli~ision of Minerals and Geology
$688.00 (Due on or before your anniversary date)
Routt
According 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 dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach ymir revised written annnal report and anmial report m to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since jor a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Kirk J. Eberl
Permittee Name: King Mountain Gravel, LLC
Address: 7276 W. Mansfield Ave.
Lakewood, CO 80235
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be
below or attach it to this form along with your written report and map.
//
Signature of Corporate Officer, Owner, or Designee
provided to the Division, please provide it
Annual Report instructions are enclosed.
Date