2005-11-21_REPORT - M2001106

• Permit No: M2001106
• IBM Index Class Name: Report
• Doc Date: 11/21/2005
• Doc Name: Annual Fee/Report/Map
• From: Huerfano County
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
i"'H erfano County
~I-2001-106
Orlando Pit
December 18, 2005
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RECEIVED
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$281.00 (Due on or before your anniversary date)
Huerfano

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
"~aperatot'shalt-sn crt-and-map-shos.•ing=the-e~ctent-sf-enrrent-disttnbanoesse-sffected-
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 y~rr revised written annnal report and annnal re nn rt 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: Bill Brunelli
Permittee Name: Huerfano County
Address: 401 Main St., Ste. 201
Walsenburg, CO 81089
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.
Signa a of Corpora a Of rcer, Owner, or Designee
~~//605
Date ~
M:~PERMI'IU7AS7ERDOCUMEN7'SN1-AF-04