REP25069

• Permit No: M1997084
• IBM Index Class Name: Report
• Doc Date: 2/1/2005
• Doc Name: Annual Report and Fee
• From: Horizon Ranch LLP
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECEIVE®
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE;
COUNTY:
Horizon Ranch, LLP
M-1997-084
Memphis
February 2,2005
$281.00 (Due on or before your anniversary date)
Ouray
FEB 0 i 2005
Division of Minerals and Ceplpgy
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,
.a ' . a ~ ~ fished-to ~ a e-preeedirrg'year,'tteva tiistnrliances-that-a?e anticipated"fo 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 anneal red nrt and anneal re~nrt mad to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Reef Gillum
Permittee Name: Horizon Ranch, LLP
Address: P.O. Box 190
Forney, TX 75126
Phone Number: [phone] 9~ a -303- 9 0 ~ ~
Fax Number: [phone] 9~~ -3u3-go3~
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.
S gnatur//e Co •porate Officer, Owner, or Desi ~
~/T? ~/O Sam/
Date