2005-09-26_REPORT - M1977170

• Permit No: M1977170
• IBM Index Class Name: Report
• Doc Date: 9/26/2005
• Doc Name: Annual Fee/Report/Map
• From: Butala Construction Company
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
/Butala Construction Company
v M-1977-170
Butala Gravel Pit
October 1, 2005
~EP 2 6 2005
~{j Division of ^.4inarcVa N' u;olayY
$688.00 (Due on or before your anniversary date)
Chaffee
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 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 anmial refit and anneal rennrt main 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 permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Frank Butala
Permittee Name: Butala Construction Company
Address: P.O. Box 907
Salida, CO 81201
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.
v u
Signa re of Corporate Officer, Owner, or Designee
9-a a-~s-
Date