2001-06-01_REPORT - M1981256

• Permit No: M1981256
• IBM Index Class Name: Report
• Doc Date: 6/1/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Yuma County
M-1981-256
Ekberg Pit
June 30, 2001
MAY 0 3 2001
RECe~~~~
JUN p 1 ?001
Division o(Minerals and Geology
$550.00 (Due on or before your anniversary date)
Yuma
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 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 vour revised written annual report and annual report map to this form. Please no[e that an
adequnlely 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-' Rich Brown Paul Like
Permittee Name: Yuma County
Address: 1310 S. Blake St.
Phone Number:
Wray, CO 80758
[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.
~~
Sigitature of Corporate Officer or Owner
Date
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