2005-08-05_REPORT - M2001052

• Permit No: M2001052
• IBM Index Class Name: Report
• Doc Date: 8/5/2005
• Doc Name: Annual Fee/Report/Map
• From: Grasser Construction Inc.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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AUG 0 5 2005
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Grasser Construction, Inc.
M-2001-052
McCormick Pit
August 2, 2005
$688.00 (Due on or before your anniversary date)
Kit Carson
Division of Mn:~..
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,
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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 ym~r revised written annnal rennrr and anm~al report 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: Jim McCormick
Permittee Name: Grasser Construction, Inc.
Address:
Phone Number:
Fax Number:
18071 CR 31
Stratton, CO 80836
[phone]
[phone]
No R o. /3ox
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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ignature of Corporate Officer, Owner, or Designee
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