2001-05-23_REPORT - M1984156

• Permit No: M1984156
• IBM Index Class Name: Report
• Doc Date: 5/23/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Grand County
M-1984-156
Grand Coty No 201 aka Scholl Gravel Pit
May 29, 2001
RECEIVED
MAY p 3 2001
~~
Division of Minerals and Geology
$550.00 (Due on or before your anniversary date)
Grand
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on [he anniversary date of [he 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 [he 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 report and annual report map to this form. Please note [hat an
adequately labeled ntap that clearly delineates and includes the above elements may suffice jor a written
report.
Division records indicate the following Permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: M C. Branstetter //~r_ - K//~iNiJ~C=~~7Z~
Permittee Name:
Address:
Phone Number:
Fax Number:
Grand County
467 E. Topaz Ave.
P.O. Box 9
Granby, CO 80446
[phone]
[phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it [o this form along with your wrirten report and map. Annual Report instructions are
enclosed.
~/~~
Signature of Corporate Officer or Owner
51~i dot
Date
M'NERM I"MIASTERDOCUM ENTSV.~-AF-04