2007-03-26_REPORT - M1977365

• Permit No: M1977365
• IBM Index Class Name: Report
• Doc Date: 3/26/2007
• Doc Name: Annual Fee/Report/Map
• From: Park County
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
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ANN) ~EE~an RE ORT REQUEST
/Park County
/~M-1977-365
Sulphur Mm Gravel Pit

RECE11lED
MAR 'L 6 2001
April 1, 2007 Divis~~~~ of Reclamation,
$281.00 (Due on or before your anniversary ~a}e`n9 and Safety
Park l
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, 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 year, reclamation that will be performed during [he coming year, the dates for the
beginning of active operations, and the date active operations ceased for the yeaz, if any.
Please attach your revised written annual report and annual 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 necessazy
changes:
Pemrittee Contact: David Kintz
Permittee Name: Pazk County
Address: P.O. Box 147
Fairplay.CO 80440
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or inforration that should be provided to the Division, please provide it
below or attach it to this form along with your written report and tnap. Annual Report instructions aze
enclosed.
Signature of Corporate Off e Owner, or Designee
.3 /3 -~7
Date