2003-07-21_REPORT - M1983209

• Permit No: M1983209
• IBM Index Class Name: Report
• Doc Date: 7/21/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Western Slope Construction Co
M-1983-209
Benton Dawson Gravel
July 25, 2003
$281.00 (Due on or before your anniversary date)
Delta
RECEIVED
JUG 2 1 ?003
Dirisian ~/ h'linerals and Geology
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,
eeelamatian-accomplished-te-date-and-durirg-the-preccdmg-year,-new-disturbances-that-are-amicipated-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 annual rennrt and annual report maw 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: Jack L. Hawkins
Permittee Name: Westem Slope Construction Co
Address: 1221 Hwy. 50
Delta, CO 81416
Phone Number: [phone]
Fax Number:
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.
nature of Corporate Officer, Owner, or Designee
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Date
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