2005-08-25_REPORT - M1989077

• Permit No: M1989077
• IBM Index Class Name: Report
• Doc Date: 8/25/2005
• Doc Name: Annual Fee/Report/Map
• From: Colorado Alabaster Supply
• To: DMG
• Media Type: D
• Archive: No

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
C ~ /~
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AMVr1AT, FF.F. and RF,PnRT RF.OTTFRT RECEIVED
Colorado Alabaster Supply ~~ ~UG 2 5 Z~~
~~ ~ivision of Minerals and GeoloBY
dM-1989-077
Colo Alabaster
August 28, 2005
$75.00 (Doe on or before your anniversary date)
Lorimer
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 submit the annual fee, a report and map showing the extent of current disturbances to affected ,
land, reclamation accomplished t~an~lc during a prec med g ye3at; ttew`disturbances thataresrttieipated-te--- -
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 ynnr revised written anneal rarnnrt and anneal rgpnrt mytp to this fnrm_ Please note that an
adequately labeled map that clearly delineates and includes the above elements may su~ee for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Stanley C. Jones
Permittee Name: Colorado Alabaster Supply
Address: 1507 N. College Ave.
Ft Collins, CO 80524
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 reap. Annual Report instructions are
enclosed.
~ ~ ~~~.
Signature of C rporate Officer; Owner, or Designee
~3~ ~ ~S
Date
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