REP34166

• Permit No: M1980121
• IBM Index Class Name: Report
• Doc Date: 2/22/2002
• Doc Name: 2002 Annual Report
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMTTTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNPJERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Weld County
M-1980-121
Pierce Pit
March 1, 2002
RECEIVED-~~
FEB 2 2 ZQ02
Division of Minerals and Geoln!av
$688.00 (Due on or before your anniversary date)
Weld
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each yeaz, 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 report and annual resort map to this form. Please note that an
adegaeately labeled map that clearly delineates and inchtdes the above elements mny since for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Greg Nelson
Permittee Name: Weld County
Address: P.O. Box 758
1111 H. S[
Greeley, CO 80632
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.
ignature Corporate Officer or Owner
Date
M:~PERMTtN1ASTERD000MENTSVN-AF-04