2005-07-17_REPORT - M1985031

• Permit No: M1985031
• IBM Index Class Name: Report
• Doc Date: 7/17/2005
• Doc Name: Annual Fee/Report/Map
• From: montezuma county
• To: dmg
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Montezuma County
M-1985-031
Mancos Gravel Pit
May 31, 2005
~E~:EIVE®
JUN 17 Z0~
Dlvlsion of Minerals and GeplpD~
$688.00 (Due on or before your anniversary date)
Montezuma
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, on the anniversary date of the permit, an
operator shall submit the annual fee, a report and maQsho_wing_the exterst of~urrent disturbances to affected _
land, reclamation accomplished to date and during the preceding year, new disturbances that aze 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 ynnr revised written annnal rennrt and annual re,Pnrt man to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffece for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Lloyd Everett
Permittee Name: Montezuma County
Address: 1680 Hwy. 145
Phone Number:
Fax Number:
Cortez, CO 81321
[phone]
[phone]
If you have additional comments andlor 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.
Date
M:~PERMIriMASTERDOCUMENTSNI-AF-n4