REP26537

• Permit No: M1999040
• IBM Index Class Name: Report
• Doc Date: 10/16/2003
• Doc Name: Annual Fee/Report Notice
• From: Rio Blanco County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

SEP-30-D3 10:36 FROM-Colorado
ih _ -
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL EEE DUE:
COUNTY:
of Nineralr i Geol oeY
Rio Blanco County
M-1999-D40
Red Wash Gravel Pit
May 17, 2003
T-T32 P.003/003 F-6gl
RECEIVE®
ocrls~
Division of Minerals and Geology
$'Z8L00 (Doe on or before yoar anniversary date)
Rio Blanco
According [o C.R.S. 34-32.5-116 or C.R.S. 34-3?-116, each year, on the anniversary date of the perm t, an
operator shall submit the anneal fee, a report and map showing the ex[ent of current disturbances to aff acted
land, reclamation accomplished to date and during the preceding year, new disturbances thaz are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming yeaz, the dates f. ~r the
beginning of active operations, and the date active operadons craned for the year, if any.
~ ca wftwe~yr r Vlc written ann of reFnrt a anm~wl remrt m+n to hs rm~m. pjeuse note tl. at an
adequarrty labeled map chat clearly delinearrs and includes rhr above elemersts may sugce for a w dtten
report.
Division rceords indicate the following pernrittee contact information. Please verify and make any nett ssazy
changes:
Pertnittee Contact Jetty Stale
Permittee Name: Rio Blanco County _
Address: 570 2nd St.
Meeker, CO 81641
Phone Number: (970} 878-5601
Fax Number: [phone] - _-
I< you have additional commetts and/or information that should be provided to the Division, please prop ide it
below or attach it to this form along with your wttten report and map. Annual Report instructions are
enclosed.
Signat Corpora tcer, Owner, or Designee
9-30-03
Date
M: VERreYIU1A$TBRDOC{nwtiMSVA.Af. W