REP25221

• Permit No: M1999018
• IBM Index Class Name: Report
• Doc Date: 4/5/2002
• Doc Name: 2002 Annual Report
• From: Wagner Construction Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Wagner Construction, Inc.
M-1999-018
Wagner Rock
April 2Q 2002
APR 0 5 2002
Division of Minerals and Geology
$281.00 (Due on or before your anniversary date)
Moffat
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, _~
~`reclautation>accomplished-to-date-a_*td-during the-precedingyear,-new-di"sturbances [fiat 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 [he date active operations ceased for the year, 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 necessary
changes:
Permittee Contact: Jay L_Wagner
Pemtittee Name: Wagner Construction, Inc.
Address: 96400 E. Hwy. 40
Craig, CO 81625
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information [hat 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' ature of Corporate Offic or Owner
'~- 2-0~
Date
M9PERM1'I~MASTERDOCUMEMSUI-AF-01