2003-08-13_REPORT - M1978266

• Permit No: M1978266
• IBM Index Class Name: Report
• Doc Date: 8/13/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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Jackson County
M-1978-266
Riley Gravel Pit
August 15, 2003
RECEIVED
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:

AUG 1 3 2003
Division of Minerals and Geology
$281.00 (Due on or before your anniversary date)
Jackson
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 shalt submit the annual-fee, arep-ort and map showing t eri extent of current rstur antes to a ecte
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 renort and anm~al rennrt maTfn 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: Harold S. Geer /~[2ISOn (.cJ. 5e.lCPJZ
Permittee Name: Jackson County
Address: P.O. Box 488
Walden, CO 80480
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.
Signature of Corporate Officer, Owner, or Designee
Date
'1-b
M:\PERMITVv7A5TERD000MENTSUI-AF-04