2006-02-13_REPORT - M2001108

• Permit No: M2001108
• IBM Index Class Name: Report
• Doc Date: 2/13/2006
• Doc Name: Annual Fee/Report/Map
• From: Alamosa County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~~
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
l/ ANNiiAi. FF.F and REPORT RF.OiTRST
j/ Alamosa Couuty
M-2001-108
Alamosa Couuty Pit No. 1
February 22, 2006
RECEIVED
`' FEB T 3 2006
~prvmon of Minenle and Geology
$281.00 (Due on ar before your anniversary date)
Conejos
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
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 re,Pn and anm.al re~prt main to this form. please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact; Phi] West ~''
Permittee Name: Alamosa County ~~
Address: 8663 S. CR 109 L--"~
L_---~-
Alamosa, CO 81101 =-~-~'"~
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 orporate Officer, Owner, or Designee
Date ~
M:WERMITMASTERD000MENTSNf-AE-04