2001-08-13_REPORT - M1978221

• Permit No: M1978221
• IBM Index Class Name: Report
• Doc Date: 8/13/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

III IIIIIIIIIIIII III
999
ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME: D Aun Mangus and LaTonne Mangus
REIL:EIVE®
PERMIT NO.: M-1978-221 AUG 13 2001
OPERATION NAME: K-Bar-T Pit Division of Minerals and G,.. ' r
ANNIVERSARY DATE: August 23,2001
ANNUAL FEE DUE: $281.00(Due on or before your anniversary date)
COUNTY: Rio Blanco
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-1 I6, 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 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 your revised written annual report and annual report map 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: D Aun Mangus
Permittee Name: D Aun Mangus and LaTonne Mangus
Address: 4160 CR 8
Meeker, CO 81641
Phone Number: [phone] (97o ) 8 78 - O 73 7
Fax Number: C %47D ) 878- 0738
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.
ignature of Corporar—offilor or Owner
lD 0 J
Date
'711l M TERM IT\MASTERDOCUM ENTSW-AF-01