2002-12-09_REPORT - M1993069

• Permit No: M1993069
• IBM Index Class Name: Report
• Doc Date: 12/9/2002
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Logan County
M-1993-069
Lindstrom Gravel Pit
November 26, 2002

FiECElVED
DEC 0 9 2002
Givision of Minerals and Geology
$281.00 (Due on or before your anniversary date)
Logan
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-[he-annual-fee,-a-report and-map showing-the-ex-tem-of~urrenrdisturbances-ro-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 your revised written annual report and annual report map to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: StreHserr
Permittee Name: Logan County
Address: 315 Main St.
Phone Number:
Fax Number:
Sterling, CO 80751
[phone]
[phone]
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If you have additional comments and/or information that should be provided to the Division, please provide i[
below or attach it to this form along with your written report and map. Annual Report instmctions are
enclosed.
~'~~ ~~
Signature of Corporate Officer, ner, or Designee
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Date
M: W ERM IT WIASTERDOCUMENTSVN-AE-04