REP19451

• Permit No: M1999064
• IBM Index Class Name: Report
• Doc Date: 8/16/2002
• Doc Name: 2002 Annual Report
• From: Luis M. Vasquez
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Luis M. Vasquez
M-1999-064
Lyon King Quarry
August 23, 2002
RECEIVEp ~ ~
AUG 16 ?p02
Division of Minerals and Geology
$281.00 (Due on or before your anniversary date)
Larimer
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. regort..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 [ha[ 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 report and annual report map 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: Luis M. Vasquez
Permittee Name: Luis M. Vasquez
Address: P,O. Box 122
Phone Number:
Fax Number:
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 Officer or Owner
g~lll-v2.
Date
Lyons, CO 80540
[phone]
M:~PERM17 VvIASTERDOCUM ENTSVN-AF-01