REP23171

• Permit No: M1989030
• IBM Index Class Name: Report
• Doc Date: 5/2/2003
• Doc Name: Annual Report
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

1 -- ,
ANNiiAi, FF.R and RF.Pf)RT RF.nIiF,ST
FiECEIVE®
PERMITTEE NAME: San Miguel County
PERMIT NO.: M-1989-030 MAY 0 2 2003
OPERATION NAME: Zadra Pit Division ~f Minerals and Geolosy
ANNIVERSARY DATE: May 15, 2003
ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date)
COUNTY: San Miguel
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 sou mrt tthe 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 your revised written annnal ren~rt and annual rennrt mad 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 snake any necessary
changes:
Permittee Contact: Mike Homer
Petmittee Name: San Miguel County
Address: P.O. Box 426
Norwood, CO 81423
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.
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Signature of Corporate Officer, Owner, or Designee
y•3o-o3
Date
M:IPERMITN1ASTERD000MENTSU-I-AF-04