2006-03-13_REPORT - M2003019

• Permit No: M2003019
• IBM Index Class Name: Report
• Doc Date: 3/13/2006
• Doc Name: Annual Fee/Report/Map
• From: Baca County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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/ 13aca County
/M-2003-019
v~ ANNfiAi, FF.F, and RF.PnRT RF.t7IiF.ST
REGC~V~~
~hAR i .~ 2006
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ht~p
Division of Minerals and G¢Wogy
Re-open gravel pit #18 Pipe Springs Ranch LLC
April 28, 2006
$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 current disturbances to affected
land-reclamation'accomplished~to date an`d-during the preceding year,~new disturbances t at aze anhc~pated 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 attaehynnr revised written anmtal re,Rprt and anm~al repo m to this form- Please note that an
adequately labeled map that clearly delineates and includes the above elements may since for a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: T~rtY Crane ~~~ ~` ~
d
Permittee Name: Baca County
Address: 741 Main St.
Springfield, CO 81073
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.
~.dt/1 ~i1tt....~c.
S gnatu of Corporate Officer, Owner, or Designee
Date
M:~PERMIPMASTERD000MEMS~hI-AF-04