2004-07-16_REPORT - M1992108

• Permit No: M1992108
• IBM Index Class Name: Report
• Doc Date: 7/16/2004
• Doc Name: Annual Fee/Report/Map
• From: Bad Boy Stone
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
,ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Bad Boy Stone
M-1992-108
Bad Boy Stone
,~;_
RECEIVED
JUL t~ g ~
February 3, 2004 Llivision of Minerals end Geology
$281.00 (Due on or before your anniversary date)
Boulder
A/ ~
e\ccording 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,
re'~ta`ma iori ac o r t~~ ed"fb~late~ ~.. `dUritg"the pretccingY ._ - _ . _ ,.
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.
Fleece attach Ynnr revised written anneal r ,port and anneal reppft map to chic 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:
Permittee Contact: Pablo Vasquez
Permittee Name: Bad Boy Stone
Address: 11493 WCR 20
Fort Lupton, CO 80621
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 wn , o esignee
_ ~- i~r
Date
M:~PE[tMITQv1 ASTERD000MENTS4M-AF-0i