2004-09-13_REPORT - M1981058

• Permit No: M1981058
• IBM Index Class Name: Report
• Doc Date: 9/13/2004
• Doc Name: Annual Fee/Report/Map
• From: Thomas F & Ginger L Latham
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~~
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Thomas F & Ginger L Latham
M-1981-058
DeBeque Gravel Pit
September 7, 2004
$688.00 (Due on or before your anniversary date)
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SEP 13 2004
Givision of Minerals & GeolOpY
According to C.R.S. 34-32.5-I 16 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,
- - -reclamation-accomplished-to-date-and-during-the-preced;ng_year, new -disturbances that are_anticipated_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 ynnr revised written annnal re~nrt and anmial 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: Harold F. Elam
Permittee Name: Thomas F & Ginger L Latham
Address: 1225 S. 7th St.
Grand Junction, CO 81501
Phone Number: [phone]
Fax Number: [phone]
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.
ignature of orporate Officer, Owner, or Designee
arold F. EIa ,President
i~e~a~~
Date