2006-04-14_REPORT - M1996008

• Permit No: M1996008
• IBM Index Class Name: Report
• Doc Date: 4/14/2006
• Doc Name: Annual Fee/Report/Map
• From: Western Gravel Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
~~
t/ ANNTiAi. FF.F, and REPORT RF.nTiF.AT

d Western Gravel, Inc.
Y M-1996-008
North R-34 Pit
Apri14, 2006
APR 142006
~IVlslaa of Minorab and Gaotoglr
$688.00 (Due on or before your anniversary date)
Montrose
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; areport-and map-showing tae extent-of current disturbances-ta-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 fir revis ~ written annual rennrt and anm~al re;Qnrt m ~n 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: Judy DeVincentis
Permittee Name: Western Gravel, Inc.
Address: 3001 N. Townsend Ave.
Montrose, CO S 1401
-- - ~-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.
Owner, or Designee
Date