2001-08-06_REPORT - M1995063

• Permit No: M1995063
• IBM Index Class Name: Report
• Doc Date: 8/6/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

• III IIIIIIIIIIIII III •
999
ANNUAL FEE and REPORT REQUEST
RECEIVED
PERMITTEE NAME: Logan County AUG 0 6 2001
PERMIT NO.: M -95- O 6 3
OPERATION NAME: Division of Minerals and Geology
ANNIVERSARY DATE: /S _
ANNUAL FEE DUE: $281.00(Due on or before your anniversary date)
COUNTY: Logan
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 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: Ken Strohson
Permittee Name: Logan-Chun o ct �( I. ,'. t
Address: 315 Main St.
Sterling, CO 80751
Phone Number: {393)533 7899 970) Sam- 7 F79
Fax Number: l' 976 ) 5= - /-O/ 9'
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.
S' nature of Corporate Officer or Owner
�/0 1
Date
M 1PFAM mMAS'MRDOCUMENTSNt-AF-04