2005-06-20_REPORT - M1982054

• Permit No: M1982054
• IBM Index Class Name: Report
• Doc Date: 6/20/2005
• Doc Name: Annual Fee/Report/Map
• From: kit carson county
• To: dmg
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNPJERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Kit Carson County
M-1982-054
Eberhart Pit
Juue 24, 2005
RC~~G~~I~
JUN 19 2005
Rivision of Minerals and Ceoloor
$688.00 (Due on or before your anniversary date)
Kit Carson
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 accomplished to date and during the preceding year, new disturbances that are 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.
Please attarh,ynnr revised written anmial rennrt and annual report main to this form. Please note [hat an
adequately labeled map that clearly delineates and includes [he above elements may since for a written
report.
Division records indicate the following permittee contactinfom~ation. Please verify and make any necessary
changes:
Permittee Contact: Lynda Brownfield ~ ~~ ~~~
Permittee Name: Kit Carson County f~
Address: P.O. Box 160
Burlington, CO 80807
Phone Number: (719} 346-8133 ~ //~ ~ r~/~ ~ /
U
Fax Number: [phone]
If you have additional commer~ls and/or information that should be provided to the Division, please provide it
below or attach it to this o along with your written report and map. Annual Report instructions are
Signature
Date
Designee
M:~PERMI'N1AS7ERDOCUMENTS~AI-AF-04