2004-07-14_REPORT - M1980112

• Permit No: M1980112
• IBM Index Class Name: Report
• Doc Date: 7/14/2004
• Doc Name: Annual Fee/Report/Map
• From: Rio Blanco County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Rio Blanco County
M-1980-112
Richard Bachman Pit
July 10, 2004
~/
RECEIVEp
JUL 14 ZpQq
Division of Minerals and GaoloBY
$688.00 (Due ou or before your anniversary date)
Rio Blanco
- -According-toG.R:S: 34-32.5-1_I6-or_CZZ.c 34_9.116 eachYear on the anniversarv date of the Hermit, 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 to
occur during the upcoming year, reclamation that will be performed during the coming yeaz, the dates for the
beginning of active operations, and the date active operations ceased for the year, if any.
Please atfachynnr revised written annual report and annual re,Pnrf m ~n fn 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:
Permittee Name:
Address:
Jerry Steele
Rio Blanco County
570 2nd St.
Meeker, CO 81641
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.
Si ature of orporate Officer, Owner, or Designee
~vn~ 2gt2OO~f
Date
M:~PERMIT~MASTERDOCUMENTSNI-AF-09