2004-09-20_REPORT - M1977170

• Permit No: M1977170
• IBM Index Class Name: Report
• Doc Date: 9/20/2004
• Doc Name: Annual Fee/Report/Map
• From: Butala Construction Company
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~a~
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Butala Construction Company
M-1977-170
Butala Gravel Pit
October 1, 2004
$688.00 (Due on or before your anniversary date)
Chaffee
~~
FiECEIVE®
SEP 2 p 2004
Divlelon of Minerals and Geology
According to C.R.S. 34=32.5-I 16 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 rennrt and anmral report m,1p_tn 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:
Pemuttee Contact: Frank Butala
Permittee Name: Butala Construction Company
Address: P.O. Box 907
Phone Number:
Fax Number:
Salida, CO 81201
[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.
~~ ~/~~C~) - awn ~ r
Signature of Corporate Officer, Owner, or Designee
Date