2005-08-30_REPORT - M1980110

• Permit No: M1980110
• IBM Index Class Name: Report
• Doc Date: 8/30/2005
• Doc Name: Annual Fee/Report/Map
• From: E-470 Public Highway Authority
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
E-470 Public Highway Authority
-1980-110
Henderson Development
September 9, 2005
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AUG 3 U 2005
~Di¢isian of Minor~ls £, Gsology
$688.00 (Due on or before your anniversary date)
Adams
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 -submiYthg-annual-fee-a report and map showing the ezfenf of current-disturbances to alfecfed land,
reclamation accomplished to date and during the preceding 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 ymrr revised written annual rennrt and annual report main, to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Matt Alexander
Permittee Name: E-470 Public Highway Authority
Address: 22470 E. 6th Pkwy.
Aurora, CO 80018
-P-hone-Number:- (909)•53-7 3470 ~~~ - ~'~n - -
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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S' ature of Corporate Officer, Owner, or Designee
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