2006-06-29_REPORT - M2004017

• Permit No: M2004017
• IBM Index Class Name: Report
• Doc Date: 6/29/2006
• Doc Name: Annual Fee/Report/Map
• From: Willits Company Inc
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
/ANNIiAi. FF.F, and RF.PnRT RF.(NTF.ST
Willits Company, Inc.
-zoo4-oil
Kattenberg Pit
July 1, 2006
RECEg~~®
~N 29 20~
Y pivlsinn of Mlno~ots and fieoloBY
$688.00 (Due on or before your anniversary date)
Grand
According to_C.R.S. 34-32.5-1.16-or C.R.S.-34-32-116,--each-year,-on the-anniversary date-af the permit, an
-operator shallsubmitahe,annual>fee,-a-report-and-map-showing-the extent cf--.currcnhdisturbances 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 atta~ynnr revised written annnal re~nrt and annnal re rTn t man 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: Bob Willits
Permittee Name: Willits Company, Inc.
Address: P.O. Box 825
Cheyenne, WY 82003
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.
J ~~
Signature of Corporate Officer, Owner, or Designee
~-2~ _D~
Date
M:~PERMIIIMASTERDOCUMENTS~M-AF-04