2004-06-29_REPORT - M1981014

• Permit No: M1981014
• IBM Index Class Name: Report
• Doc Date: 6/29/2004
• Doc Name: Annual Fee/Report/Map
• From: Valco Gunnison Concrete Division
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~~
PERMITTEE NAME:
:PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
.ANNUAL FEE DUE:
COUNTY:
~/

Valco Gunnison Concrete Division
M-1981-014
Rozman Pit
June 29, 2004
RECEIVED
JUN 2` g ~
Division of Minereie and GeolaBY
$688.00 (Due on or before your anniversary date)
Gunnison
.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
:>hall submit the annual fee, a report and map showing the extent of cun•ent disturbances to affected land,
rec amatron accompu"shed io date-and-daring-the-preceding-year-new-dishrrhances_that_aze_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 ynnr revised written anneal rennrf and anneal re~nrt main in 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:
1'ermittee Contact: Ed Stewart
Pennittee Name: Valco Gunnison Concrete Division
Address: P.O. Box 837
Gunnison, CO 81230
Phone Number: [phone]
I~ax 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 Corporate Offi er, Owner, or Designee
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Llate