2004-06-01_REPORT - M1983216 ‎(2)‎

• Permit No: M1983216
• IBM Index Class Name: Report
• Doc Date: 6/1/2004
• Doc Name: Annual Fee/Report/Map
• From: Mesa County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME: Mesa County ,/
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PERMIT NO.:
M-1983-215 n
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OPERATION NAME: Wright Draw Pit ~ an~~B0to9Y
ANNIVERSARY DATE: June 11, 2004
ANNUAL FEE DUE: $281.00 (Due on or before your anniversary date)
COUNTY: Mesa
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 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 ynnr revised written anm~al report and anmial rP~nrt m to this Fnrm. 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 pennittee contact information. Please verify and make any necessary
changes:
Petmittee Contact:
Permittee Name:
Address:
Bud Thompson
Mesa County
1000 S. 9th St.
P.O.Box 20000-5025
Grand Junction, CO 81501-5025
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.
u
Signature of Corporate Officer, caner, or Designee
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Date