2003-10-09_REPORT - M2002068

• Permit No: M2002068
• IBM Index Class Name: Report
• Doc Date: 10/9/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Rick Ensminger
M-2002-068
Ensminger Pit
July 29, 2003
$281.00 (Due on or before your anniversary date)
Phillips
OCT 0 9 2003
9F~ision of PAirerals and G~-
4 According to C.R.S. 34-32.5-116 or C.R.S. 34-32=1.16, each year, on the_apniversary 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-[D=octor
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 rennrt and anmlal rennrt man to this 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: Rick Ensminger
Permittee Name: Rick Ensminger
Address: 3500 Hwy. 6
~3oX211o
Haxtun, CO 80731
~~x ~~ ~
Phone Number: [phone]
_- - J --Fax-Number:- - ----° -- -° - - -- - ~ - - ~ 1-17 =~ ~_ •~ ~ ~3 3 _ - - - --
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, Own , or Designee
l v • 03
Date
M:~PERMITU~fASTERDOCUMENTSVN-AFAI