2005-01-11_REPORT - M1978357

• Permit No: M1978357
• IBM Index Class Name: Report
• Doc Date: 1/11/2005
• Doc Name: Annual Fee/Report/Map
• From: Grand Junction Pipe & Supply Co.
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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(_~~QL\r ANNiiAi, FF.F, and RF.P(1RT RF.niTF ST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Grand Junction Pipe & Supply Co.
M-1978-357
Bradbury Pit
January 25, 2005
1
~4i.,~
JAN i i 2G~5
6ivisiou n?I~...
$688.00 (Due on or before your anniversary date)
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_annua)-fee, a_report and_map_showing_the_extent_of~urrent_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 yeaz, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please aftach~nnr revised written anneal re~nrt and anneal renort ma~tn 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: Edwazd J. Settle
Permittee Name: Grand Junction Pipe & Supply Co.
Address: P.O. Box 1849
Grand Junction, CO 81502
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.
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Signature of rporate Officer, Owner, or Designee
{c'--'2cc~5~
Date