2006-09-28_REPORT - M2004048

• Permit No: M2004048
• IBM Index Class Name: Report
• Doc Date: 9/28/2006
• Doc Name: Annual Fee/Report/Map
• From: Robert Daugherty
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
/Robert Daugherty
/~~M-2004-048
/Cedar Point Picture Rock Quarry
October 4, 2006
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RECEIVED
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/Division of Reciamation,
Mining and Safety
$281.00 (Due on or before your anniversary date)
San Miguel
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 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 are anticipated to occur
and ng t~upcommg year, rec amahon t at wiIl~e peed during tfie coming year, the ~ tes tb~ tfie beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach vour revised written annual report and annual reuort map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, resort, and associated
moo. If no new disturbances or reclamation have occurred durinc the previous vear and no new chances to
the urevious year's map are necessary, then no new moo is required, provided that the Operator shall state
this in the Annual Report. 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 pennittee contact information. Please verify and make any necessary
changes:
Permittee Contact
Permittee Name:
Address:
Phone Number:
Fax Number:
Robert Daugherty
Robert Daugherty
P,O. Box 1364
Clifton, CO 81520
(970}434-8773
[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.
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Signature of Corpte O er, Owner, or Designee
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