2002-01-24_REPORT - M1981287

• Permit No: M1981287
• IBM Index Class Name: Report
• Doc Date: 1/24/2002
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

_:
PERMITTEE NAME:
PERI\1IT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
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999
ANNUAL FEE and REPORT REQUEST
Nikolaus Amusch
M-1981-287
Arnusch Grav Pi[ 3
February 25, 2002
RECEIVED
JAN 2 4 2002
DIVISI00 of Minerals and Geology
$281.00 (Due on or before your anniversary dates
Weld
4,~
According to C.R.S. 34-32.5-I 16 or C.R.S. 34-32-I 16, each year, on the anniversary date of [he 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 preccdin~ 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 nn
ndeyunreh~ labeled nwp rltat clearly delineates and indtrdes the above elements mm• since for a ~rritten report.
Division records indicate the following permit[ee contact ihfonnatlon. Please verify and make any necessary
changes:
Permit[ee Contact: Nik Amusch
Permittee Name: Nikolaus Amusch
Address: 34527 WCR 6
Keenesburg, CO. 80643
Phone Number: [phone]
Fax Number:
~~- ~i5'.4/rG'ES
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it [o this form along with your written report and map. Annual Report instructions are enclosed.
Signature of Corporate Officer or Owner
,~ 23 n2
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M NERA11N1ASTERD000MENTSNI-AF~01