2005-08-25_REPORT - M2004026

• Permit No: M2004026
• IBM Index Class Name: Report
• Doc Date: 8/25/2005
• Doc Name: Annual Fee/Report/Map
• From: Leone Sand and Gravel LLC
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COLJN"I'Y:
Leone Sand and Gravel, LLC~~
~M-2004-026
Leone Gravel Pit
August 25, 2005
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~AUG 2 5 2005
Divisioa of i14ii,cr;~s & Geolapy
$688.00 (Due on or before your anniversary date)
Las Animas
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the pennit, an operator
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~ria,r--~. ~,.~ a ee,-a-re^P rt-a..e-. ap-s owmg._t e_extent_o _current_ istuz ances_to_a ecte__ an , _
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be perfonned 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 re;nort and annual re on rt mgp 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: Frank L. Leone
Permittee Name: Leone Sand and Gravel, LLC
Address: 502 S. Walnut St.
Trinidad, CO 81082
Phone Number:_ __(719) 846-4170
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.
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Signature of Corporate Offi er, Owner, or Designee
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Date