2006-09-22_REPORT - M1985038

• Permit No: M1985038
• IBM Index Class Name: Report
• Doc Date: 9/22/2006
• Doc Name: Annual Fee/Report/Map
• From: Colorado Lien Company
• To: DRMS
• 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:
ANNUAL FEE and REPORT REQUEST
Colorado Lien Company °~
'~M-1985-038
Rifle Quarry
September 26, 2006
~~CE~U~D
CEP 2 2 2006
Dlvlslon of Reclamation,
Mining and Safety
$688.00 (Due on or before your anniversary date)
Garfield
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 subniii the -annual 'fee, a-report and enap 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 your revised written annual report and annual report mau to this form. The Annual Report &
Fee requirement is not met until we have received the following components: fee, report, and associated map
(All are required regardless of the level of disturbance or absence of disturbance during the previous year).
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:
Permittee Name:
Address:
Shelly Erickson
Colorado Lien Company
P.O. Box 440

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Rapid City, SD 57709
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or infomration that should be provided to the Division, please provide it below
or attach i}t~to this form along with your written report and map. Annual Report instructions are enclosed.
c~'I
Signature of o orate Officer, Owner, or Designee
9-/$'~(a
Date