2004-06-01_REPORT - M1983216

• Permit No: M1983216
• IBM Index Class Name: Report
• Doc Date: 6/1/2004
• Doc Name: Annual Fee/Report/Map
• From: Mesa County
• 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:
Mesa County
M-1983-216
Lumsden Canyon Pit
June 11, 2004
~~
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Mineraisa y yca/joy
$281.00 (Due on or before your anniversary date)
Mesa
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, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming yeaz, 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 ymm revised written annual rennrt and anmial report main to this form- Please note that an
adequately labeled map that clearly delineates and includes the above elements may since jor a written
report.
~ Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Pennittee Contact: Bud Thompson
Permittee Name:
Address:
Phone Number:
Fax Number:
Mesa County
1000 S. 9th St.
P.O. Box 20000-5025
Grand Junction, CO 81501-5025
[phone]
[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.
Signature of Corporate Offic~,~Owner, or Designee
Date