REP30318

• Permit No: M1977485
• IBM Index Class Name: Report
• Doc Date: 9/9/2002
• Doc Name: 2002 Annual Report
• From: Baca County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATF_:
ANNUAL FEE DUE:
COUNTY:
ANNUAL rPl's and RCPORT RIsOU1;ST
Baca County
M-1977-485
Gravel Pit No 8
September ] 1, 2002

RECE6~lED
SEP 0 9 2002
Dirisioa of Minerals and Geology
$688.00 (Due on or before your anniversary date)
Baca
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on [he 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 daft and during the preceding year, new disuubances that arc :utlicipated to
occur 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.
Please attach your revised written annual report and annual report map to this form. Please note that rm
nde~uately labeled mop that clearly delineates and includes the above elements nmy suffice for n written
report. ' '"'
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Division records indicate the following permittee contact information. Please verify and make any necessary ~'a
changes:
Pcrmittee Contact: Troy Crane
Pcnnitlcc Namc: []aca County
Address: 741 Main St.
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Springfield, CO 81073
Phone Number: [phone]
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~;,<;Fax Number. [phone]
]f you have additional comments and/or information that should be provide) to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instntctions are
enclo; I d.
ignatntlrof Corporate Officer, Owner, or Designee
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