2002-08-21_REPORT - M1977184

• Permit No: M1977184
• IBM Index Class Name: Report
• Doc Date: 8/21/2002
• Doc Name: 2002 Annual Report
• From: City of Fort Collins
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMI"1`CEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
City of Fort Collins
M-1977-184
Timberline Pit
August 15, 2002
$688.00 (Due on or before your anniversary date)
Larimer
RECEIVED
AUG 2 1 2002
Division of Minerals and Geology
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 cnhn,;r rt,P a.,.,~,at fPP a repnn and man slrQwin>' the_extent~f current disturbances to affected land~__
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation [hat will be performed during the coming year, the dates for [he beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach vour revised written annual report and annual report mau to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may scrffice for a written report.
Division records indicate the following petmittee contact information. Please verify and make any necessary
changes:
Permittee Contact Mark Sears
Permittee Name: City of Fort Collins
Address: 281 N. College Ave.
P.O. Box 580
Fort Collins, CO 80522
Phone Number: [phone]
Fax Number:
~Q~~ 2esva~ces Deo mewf
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.
Sign tore of Corporate Officer or Owner
~/i/o z
Date
M1PERMITh1ASTERDOC UM ENTSVN-AF-01