2001-12-17_REPORT - M1985200

• Permit No: M1985200
• IBM Index Class Name: Report
• Doc Date: 12/17/2001
• Doc Name: Annual Fee/Report/Map
• 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:
III IIIIIIIII IIII III
999
ANNUAL FEE and REPORT REQUEST
Morgan County
M-1985-200
Kula Gravel Pit
December 18, 2001
ECElVED
'~ DEC 1 7 2001
Dir~sion of Minerals and Geology
$281.00 (Due on or before your anniversary date)
Morgan
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary da a of [he permit, an
operator shall submit the annual fee, a report and map showing the extent of current dist rbances [o affected
land, reclamation accomplished to date and during the preceding year, new disturbances t a[ are anticipated to
occur during the upcoming year, reclamation that will be performed during the coming y ar, 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
adequately labeled map that clear[v delineates and inchtdes the above elements may ffce for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Joe B. Baltazar
Permittee Name: Morgan County
Address: 17303 CR S
Ft Morgan, CO 80701
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Divisi n, please provide it
below or attach it to this form along with your written report and map. Annual Re rt instructions are
enclosed.
gnature of Corporate Off er or Owner
/,2-~jr..~/
Date
M:~PER h11TM ASTER DOCU M ENTSNI-AF-61