2001-04-19_REPORT - M1988032

• Permit No: M1988032
• IBM Index Class Name: Report
• Doc Date: 4/19/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
PERM[TTEENAME: Washington County RECEIVE®
PERMIT NO.: M-1988-032 APR 19 20:1
OPERATION NAME: Fassler Gravel Pit
Oiuision of Minerals Bnd Geology
ANNIVERSARY DATE: May 18, 2001
ANNiJAL FEE DUE: $225.00 (Due o0 or before your anniversary date)
COUNTY: Washington
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-]16, 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 your revised written annual report and annual resort maa to this form. P/ease note that an
adequately labeled Wrap that clearly delineates and includes the above elements may suffice jor a written
report.
Division records indicate the following pennittee contact information. Please verify and make any necessary
changes:
Pennittee Contact: Willie Sanders
Permittee Name: Washington County
Address: 150 Ash St.
Phone Number:
Fax Number:
Akron, CO 80720
[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.
Signature of C rporate Officer or Owner
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Dale
M'~PERMITMASTERDOCUA~NTSUI-AF-04