2005-07-19_REPORT - M1983119

• Permit No: M1983119
• IBM Index Class Name: Report
• Doc Date: 7/19/2005
• Doc Name: Annual Fee/Report/Map
• From: kiowa county
• To: dmg
• Media Type: D
• Archive: No

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ANNiiAi. FF,F. and REPORT RF.t7iTFST
PERMITTEE NAME: Kiowa County JUL 1 9 2005
PERMIT NO.: M-1983-119
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OPERATION NAME: Chivington Grazing
ANNPJERSARY DATE: August 25, 2005
ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date)
COUNTY: ICiowa
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
operatarshal3-sirhmit the annual-fee,-a report-and-map showing the extenCof current-disturbances to affected
land, reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming yE;ar, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please attach ynnr revised written anneal rennrt and anm~al red nrt 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:
Pennittee Contact: Rodney Hopkins
Permittee Name:
Address:
Phone Number:
Fax Number:
Kiowa County
P.O. Box 100
Eads, CO 81036
[phone]
[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 aze
enclosed.
Signature of Carp rate O tc ,Owner, or Designee
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Date
M:~PERMf71MASTERDOCUMENTSIM-AF-04