2003-08-21_REPORT - M2000084

• Permit No: M2000084
• IBM Index Class Name: Report
• Doc Date: 8/21/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Washington County
M-2000-084
Chris Aaegeson Pit ~`2
August 30, 2003
AUG 2 1 2003
Division ~f Minerals and Geology
$281.00 (Due on or before your anniversary date)
Washington
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 exient 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 anmral reoTrt and annnal red ort map to this fnrm_ 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 contacti.nformation. Please verify and make any necessary
changes:
Permittee Contact: Charles J. Kuntz ,~~.ei_,P.PivaJ
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Permittee Name: n
Washington County ,~~ fn r~J 1 as a-~,a~aunta i
Address: 150 Ash ~. , ~,¢.~i~-~~,,,. ,
7 n-
Akron, CO 80720 ~1/J_~~n.~~,,siFa.~~i -
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Phone Number: [phone] (_i!'~~' Q/ ~ ~7_
Fax Number: [phone] ~,d-13-.~,r~u~
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.
Signature of Corporate Officer, Owner, or Designee
Date
M:~PERM nVv1ASTERD000MENTSUA-AF-09