2005-12-01_REPORT - M1977500UG

• Permit No: M1977500UG
• IBM Index Class Name: Report
• Doc Date: 12/1/2005
• Doc Name: Annual Report
• From: Russell D Neesham
• To: DMG
• Media Type: D
• Archive: No

~y~lu~ ~ ~l°%
PERMTTTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
~ R/ussell D Newham
//M-1977-500-UG
Peggie Miues
Juue 29, 2005
~,ECEIVED
dpEC G 1.005
..,.. ,;; i~imerala and Geolepy
$225.00 (Due on or before your auuiversary date)
Montrose
sss
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, 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 aze 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 yeaz, if any.
Please att9rh ym.r revised written 9nnn91 rennrt and 9nnnal rpnnrf mn~ to thin 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: Russell D. Newham
Permittee Name: Russell D Newham
Address: P.O. Box 314
Nucla, CO 81424-0314
Phone Number: [phone]
Fax Number:
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. ~ .2c c c,-/ G'-G~-~'~t~2(~ .."•---C_
~~ ~ ~ .
~ "lam%L ,..~~,'~~.
S' ~~a~~~~re of Corporat~fficer, er, or esl~e
Date
M:~PERMITNIASTERDOCUM ENTS/M-AF-02.DOC