REP15687

• Permit No: M1981004
• IBM Index Class Name: Report
• Doc Date: 1/31/2003
• Doc Name: Annual Report
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Dilleys Sand & Gravel
M-1981-004
Ayers Pit
February 2, 2003
$281.00 (Due on or before your anniversary date)
Morgan
JAN.3 1 2003
Division of Minerals and Geobgy
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,
rec ama ion acco p o e durni g ttse'p~ding year-crew-distarban~es-that-are-anticipated-t~ 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 Ynur revised written anneal re,~nrt and annual rennrt m t to this form- Please note that an
adequately labeled map that clearly delineates and includes the above elements may sujf ce for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Vernon Dilley
Permittee Name: Dilleys Sand & Gravel
Address: 1914 Edmunds St.
P.O. Box 125
Brush, CO 80723
Phone Number: [phone]
Fax Number: (970} 842-2284
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.
ignature of Corporate Officer, Own o Designee
_~- a 9- a 3
Date
M:NERMINIASTERD000MENTSU4-AF-0 ~