2001-12-06_REPORT - M2000092

• Permit No: M2000092
• IBM Index Class Name: Report
• Doc Date: 12/6/2001
• 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:
ANNUAL FEE and REPORT REQUEST
City of Walsenburg
M-2000-092
Walsenburg Gravel Pit
December 14, 2001
$281.00 (Due on or before your anniversary date)
Huerfano
RECEIVED
DEC 0 6 2001
Drrisios of Minerals and Geeloq~
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-]l6, 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 [hat 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 vour revised written annual resort and annual resort maa to this form. Please note that art
adequately labeled map that clearly delineates and includes tite nbove elements may suffice for a writrert
report.
Division records indicate the following permi[tee contact information. Please verify and make any necessary
changes:
Permittee Contact: Fred A. Rodriquez
Permittee Name: City of Walsenburg
Address: 525 S. Albert
Walsenburg, CO 81089
Phone Number: [phone]
Fax Number: [phone]
Maurice J. Brau
Citv of Walsenburo
525 South Albert Street
Walsenburg, CO 81089
(714)77A-1 ndR I
[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.
~~
Signature--of//Cory ate Officer or Owner
~y0y~0/
Date
M:~PERM aw1ASTER DOC U M ENTSN7-AF-OJ