2004-05-19_REPORT - M1983037

• Permit No: M1983037
• IBM Index Class Name: Report
• Doc Date: 5/19/2004
• Doc Name: Annual Fee/Report/Map
• From: Louis M. Wyman
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Louis M. Wyman
M-1983-037
Wyman Pit
May 31, 2004
RECEIVE®
MAY 19 2004
BiniSion ~f Minerals and Geelagy
$281.00 (Due on or before your anniversary date)
Routt
N
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,
_ ~_ _te~jamation accomplished to date and during the preceding_yeaz, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming yeaz, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written anneal re_pnrt and anneal reQnrt maw 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:
Permittee Name: Louis M. Wyman
Address: P.O. Box 278
Phone Number:
Fax Number:
Craig, CO 81626
[phone]

below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
y~l
Signature of Corporate Officer, Owner r Designee
S /S _ d
Date
it