2001-03-19_REPORT - M1985008

• Permit No: M1985008
• IBM Index Class Name: Report
• Doc Date: 3/19/2001
• 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 REOUEST �ECEIVED
PERMITTEE NAME: Orlando & Rose Marie Martinez MAR 19 2001
PERMIT NO.: M-1985-008 Div
+sion of Minerals and Geology
OPERATION NAME: Leone-Gardner Gravel
ANNIVERSARY DATE: March 22,2001
ANNUAL FEE DUE: $281.00(Due on or before your anniversary date)
COUNTY: Huerfano
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary d to of the permit. an
operator shall submit the annual fee, a report and map showing the extent of current di urbances 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 actiye.operations ceased for the year, if any.
Please attach your revised written annual report'and annual report map to this form. Please note that ar,
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: CF.PR.contact first name CF.PR.COntact last name
Permittee Name: Orlando& Rose Marie Martinez
Address: 1 Kiowa
Pueblo, CO 81006
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Di ision, please provide it
below or attach it to this form along with your written report and map. Annual eport instructions are
enclosed.
Signature of Corporate f fce.r or Owner
Dat�—' Ir�OO�
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