2004-07-21_REPORT - M1979089

• Permit No: M1979089
• IBM Index Class Name: Report
• Doc Date: 7/21/2004
• Doc Name: Annual Fee/Report/Map
• From: Grand Junction Pipe & Supply Co.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Grand Junction Pipe & Supply Co.
M-1979-089
23 Road Pit
July 25, 2004
$688.00 (Due on or before your anniversary date)
Mesa

-AcLOrding-to C.R.S..3432.5-L16 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 attac~ynnr reviced written anneal re~rt and annual report manrtn 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:
Phone Number:
Fax Number:
Edward J. Settle
Grand Junction Pipe & Supply Co.
P.O. Box 1849
Grand Junction, CO 81502
[phone]
[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 yow written report and map. Annua] Report instructions are enclosed.
Signature o Corporate Officer, Owner, or Designee
7_c,_oQ
Date