2001-12-21_REPORT - M1983148

• Permit No: M1983148
• IBM Index Class Name: Report
• Doc Date: 12/21/2001
• 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 REQUEST
RECEIVED
DEC 1 1 2001
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Montrose County
M-1983-148
Neal Pit
January 30, 2002
$688.00 (Due on or before your anniversary date)
Montrose
Division of Minerals and GeeloAY
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 vour revised written annual report and annual report map to this form. Please note that art
adequately labeled map that clearly delineates and incktdes the nbove elements may suffice for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Brian Wilson
Permitlee Name: Montrose County
Address: 161 S. Townsend
Montrose, CO 81401
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.
Si azure of Corporate Officer or Owner
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