2003-06-26_REPORT - M1985100

• Permit No: M1985100
• IBM Index Class Name: Report
• Doc Date: 6/26/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~_
FiECEIVE®
JUN 2 6 2003
Division ~f Minerals and Geology
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Baca County
M-1985-100
Gravel Pit No 23
July 25, 2003
$281.00 (Due on or before your anniversary date)
Baca
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-currenCdisturbances 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 ynnr revised written annual rennrt and annual rennrt m ~n 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: ~'Ped-Easley
Permittee Name: Baca County ~,~ ~., .
Address: 741 Main St. `J ~ ~y,.o-cJ..r 1>/ ~~~pp
Springfield, CO 81073 S.to.t,...,.~,Q1,.Q~ - L.tlrO,
Fax Number: [phone]
714 :~a.3 - Gsg ~
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.
Srgnature of Corpor Owner, or Designee
l~ _ _ -03
Date
M:~PERMITUTASTER DOCUM ENTSUI-AF-04