2007-02-16_REPORT - M1995005

• Permit No: M1995005
• IBM Index Class Name: Report
• Doc Date: 2/16/2007
• Doc Name: Annual Fee/Report/Map
• From: Mountain Region Corporation
• 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:
ANNUAL FEE and REPORT REQUEST
fjN~I ntain Region Corporation
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Orchard Mesa Aggr
February 16,2007
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nin9 and Sa eat/oq
$$68$.00 (Due on or before your anniversary date)
Mesa
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
__ _ _shalLsubmit the. annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation accomplished to date and'dunng tthe precedingig'year,"new'disturbances that-are-anticipated-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. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
map. If no new disturbances or reclamation have occurred durinc the previous year and no new chances to
the previous year's map are necessary, then no new map is required, provided that the Operator shall state
this in the Annaal 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 permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Sandra R. DuCray
Permittee Name: Mountain Region Corporation
Address: 117 - 29 3/4 Rd.
Grand Junction, CO 81503
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 Offi ,Owner, or Designee
Note: No disturbances or reclamation
has occurred during the previous
year.
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Date