REP26009

• Permit No: M1981114
• IBM Index Class Name: Report
• Doc Date: 7/1/2006
• Doc Name: Inadequate Letter
• From: DMG
• To: La Plata County
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
PERMTITEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
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 aze anticipated to
occur during the upcoming yeaz, 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 annnal report and annual report man 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:
La Plata County
M-1981-114
Crader Gravel Pit
June 27, 2006
$688.00 (Due on or before your anniversary date)
La Plata
Permittee Contact: Walter A. Serfoss
Permittee Name:
Address:
La Plata County
1365 S. Camino Del Rio
Durango, CO 81303
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.
Signature of Corporate Officer or Owner
Date