2004-05-13_REPORT - M2000037

• Permit No: M2000037
• IBM Index Class Name: Report
• Doc Date: 5/13/2004
• Doc Name: Annual Fee/Report/Map
• From: Rio Blanco County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~ G
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
According to C.R.S-34=32.5=1'1Y, or C:R.S. 34-32-116, eacls year, on"the anniversary date of the pet`mit, an
_ _operator shall submit the annual fee, a report and m_ap 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 ynnr revised written annnal rennrt and anmral report maw to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written
report.
Rio Blanco County REC+EA~~®
M-2000-037
Baxter Pass Gravel Pit MAY 13 2004
May 10, 2004 Ojyjsjya of Minersk~ 8llyolagY
$281.00 (Due on or before your anniversary date)
Rio Blanco

Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Pennittee Contact:
Permittee Name:
Jerry Steele
Rio Blanco County
Address:
Phone Number:
Fax Number:
570 Second St.
Meeker, CO 81641
[phone]
[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.
Si lure of Co or to O facer, Owner, or Designee
Date
M:~PERMITVNASTERD000MENTS~M-AF-04