2002-08-07_REPORT - M1985100

• Permit No: M1985100
• IBM Index Class Name: Report
• Doc Date: 8/7/2002
• Doc Name: 2002 Annual Report
• From: Baca County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
RECEIVED
ANNUAL FEE and REPORT REOUESTG ~ T 2002
Baca County Division of Minerals and Geology
M-1985-100
Gravel Pit No 23
July 25, 2002
$281.00 (Due on or before your anniversary date)
Baca
No ~
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I16, each yeaz, on [he 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 vour 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: Ted Lesley
Permittee Name: Baca County
Address: 741 Main St.
Springfield, CO 81073
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 Corporate Of tcer or Owner
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Date
M 1PL•RMI'IN1 ASTERDOCUMENTSN1-AF-04