2004-07-20_REPORT - M1984040

• Permit No: M1984040
• IBM Index Class Name: Report
• Doc Date: 7/20/2004
• Doc Name: Annual Fee/Report/Map
• From: Larry L. Chartier
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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Larry L. Chartier
M-1984-040
Chartier Pit
July 19, 2004
RECE111ED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
r
N
JUL 2 0 2004
Division of Minerals & 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-I 16, each yeaz, on the anniversary date of the permit, an operator
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 far the year, if any.
Please attach ymrr revised written anm.al re~rt and anneal re~nrt main 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: Larry L. Chartier
Permittee Name: Larry L. Chartier
Address: 21305 Road 28.5
Phone Number:
Fax Number:
Brush, CO 80723
[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.
C
Signature of C orate Officer, Owner, or Designee
~--~ R- ~~
Date