REP22166

• Permit No: M2000073
• IBM Index Class Name: Report
• Doc Date: 6/14/2002
• Doc Name: 2002 Annual Report
• From: Rio Blanco County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Rio Blanco County
M-2000-073
Shults Gravel Pit
June 27, 2002
RECEIVED
JUN 1 4 1002
Division of Minerals and Geology
$281.00 (Due on or before your anniversary date)
Rio Blanco
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of [he permit, an
operator shall submit the annual fee, a report and map showing the extent of curzent disturbances to affected
land, reclamation accomplished to date and d3rPrig 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 dote that art
adequately labeled map that clearly delineates and inchrdes the above elements may srffce for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Jerry Steele
Permittee Name: Rio Blanco County
Address: 570 2nd St.
Meeker, CO 81641
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 lure of rporate Officer or Owner
5-3o-oa
Date
M:NERMI71MAS7ERD000MENTSN4-AF-W