REP17098

• Permit No: M1998022
• IBM Index Class Name: Report
• Doc Date: 8/1/2006
• Doc Name: Inadequate ltr
• From: DMG msr
• To: The Gallegos Corporation
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMTTTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
The Gallegos Corporation
M-1998-022
Conger Harvesting Area
June 5, 2006
$281.00 (Due on or before your anniversary date)
Gunnison
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the azmiversary date of the permit, an
operator shall submit the annual fee, a report and map showing the extent of cunent disturbances to affected
]and, reclamation accomplished to date and during the preceding yeaz, new disturbances that aze anticipated to
occur during the upcoming yeaz, 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.
• revised written annual report and annual report map to this form. Please note that an
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: Robert M. Gallegos, Jr.
Permittee Name: The Gallegos Corporation
Address: P.O. Box 821
Vail, CO 81658
Phone Number: [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.
Signature of Corporate Officer or Owner !
Date ~~