2004-08-30_REPORT - M1981112

• Permit No: M1981112
• IBM Index Class Name: Report
• Doc Date: 8/30/2004
• Doc Name: Annual Fee/Report/Map
• From: Builders Aggregate Company Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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ANNiTAi. FF.F, and RFPnRT RF.Oi1F.ST RGL`~I V ~~
PERMITTEE NAME: Builders Aggregate Company, ine. AUG 3 0 ~
PERMIT NO.: M-1981-112 Oluislon of Minerals and GeoloBY
OPERATION NAME: Builders Aggr Pit
ANNNERSARY DATE: September 1, 2004
ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date)
COUNTY: Morgan
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,
reelamation-aecomFlished-to -date-and during -the-preced.ngyear,-ncw-dishrrbances'that -are-anticipated-to-aacur
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 Xpnr revic d written annual re~prt and annual rennrt map to this 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 pennittee contact information. Please verify and make any necessary
changes:
Pennittee Contact:
Permittee Name:
Address:
Phone Number:
_ _Fax Number:
James S. Miner
Builders Aggregate Company, Inc.
915 W. Beaver Ave.
Ft Morgan, CO 80701
[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.
t
ignature of Corporate Officer, Owner, or Designee
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Date