2007-01-24_REPORT - M1992009

• Permit No: M1992009
• IBM Index Class Name: Report
• Doc Date: 1/24/2007
• Doc Name: Annual Fee/Report/Map
• From: Gillette Sand and Gravel, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
`/ ANNUAL FEE and REPORT REQUEST
/Gillette Sand and Gravel, Inc.
M-1992-009
Gillette Pit
February 9, 2007
a-~s° °7
R~CFI~~~D
~~'/JAN 2 4 2001
- `"'~~siOn °f Reclamation,
Mining and Safety
$$688.00 (Due on or before your anniversary date)
Teller
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,
- -reclamation accomplishcd-to-date and-during 4he preceding year,-new-disturbances tha^ t 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 yeaz, if any.
Please attach your revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
moo. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to
the previous year's map are necessary, then no new map is required, provided that the Operator shall state
this in the Annual Report. 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 permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: V. C. Pyles
Permittee Name: Gillette Sand and Gravel, Inc.
Address: 20575 Highway 24
Woodland Park, CO 80863
Phone Number: [phone]
Fax Number:
1f you have additional comments and/or information that should be
below o ac it to this form along with your written report and map.
Signature of Corporate Officer, Owner, or Designee
provided to the Division, please provide it
Annual Report instructions are enclosed.
~ I ~ a,3 ~ a.Od`~l
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