2005-09-15_REPORT - M1989092

• Permit No: M1989092
• IBM Index Class Name: Report
• Doc Date: 9/15/2005
• Doc Name: Annual Fee/Report/Map
• From: Oaklands Ranch
• To: DMG
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
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O/aklands Ranch ~.
//M-1989-092
Oaklands Ranch
October 26, 2005
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l~S~EP 1 5 2005
~7ivisinn of PAinerai~
$281.00 (Due on or before your anniversary date)
Douglas

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 curreni disiurliances to affected Iand, ~ -
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 anneal report and anneal report main 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: David Curtis
Permittee Name: Oaklands Ranch
Address: 1613 N. Perry Park Rd.
Sedalia, CO 80135-8511
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.
ice.
Signa a of Corporate Officer, Owner, or Designee
9-~y~-o~
Date