2003-01-17_REPORT - M1977522

• Permit No: M1977522
• IBM Index Class Name: Report
• Doc Date: 1/17/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECE9 VED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
River Valley Rock, Inc.
M-1977-522
Herman Feit Pit
March 23, 2003
$688.00 (Due on or before your anniversary date)
Weld
JAN 17 2003
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 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 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 rennrt and anneal re ern t man 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: Al Lunbery
Permittee Name: River Valley Rock, Inc.
Address: P.O. Box 967
Greeley, CO 80632
Phone Number: [phone]
Fax Number:
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.
(~CX l~~il
Signature of Corporate Office ,Owner, or Designee
Date
M:~PERM ITUTASTERDOCUMENTSU-I-AF-01