2001-08-06_REPORT - M1976020

• Permit No: M1976020
• 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

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ANNUAL FEE and REPORT REOUEST Wrj 6 1� GGO
PERMITTEE NAME: Mountain Gravel and Contraction Copfkppe�B\��`
PERMIT NO.: M-1976-020 PvV 0� reao
OPERATION NAME. Thomas Pit D`�tgo�o�tA��e
ANNIVERSARY DATE: July 28,2001
ANNUAL FEE DUE: $688.00(Due on or before your anniversary date)
COUNTY: La Plata
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 rote that an
adequately labeled neap that clearly delineates and includes the above elements may suffice for a written
report.
Division records indicate the following pertnittee contact information. Please verify and make any necessary
changes: .�
Permittee Contact: `—n,� d-;ibbits � .4w—r n
Permittee Name: Mountaso Gravel and Gontruction
Address: 601 Central Ave.
P.O. Box 788 1=6. &3- c Z70 7
Dolores, CO 81323 �. r��_- O . rD �5 1
Phone Number: [phone] Q� 70 — 2.c-k 7 — k1 7 c
Fax Number: 1 70 2,51— 36 3 I
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
Date
M APERMF[W ASTERDOCUMENTSNt-AF-01