2002-12-12_REPORT - M1988057

• Permit No: M1988057
• IBM Index Class Name: Report
• Doc Date: 12/12/2002
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMTTTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Canyon Sand & Gravel
M-1988-057
Canyon Sand & Gravel
August 16, 2002
RECEdVE®
DEC i 2 ?ppy
Division of Minerals and Geology
$251.00 (Due on or before your anniversary date)
Archuleta
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
-"' '- -shah submit th'e annual-fee,-a-report and map showing-tne exteni of cu`rreat dt`sturbances 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 vour revised written annual report and annual report map to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may since far a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact:
Permittee Name:
Address:
Robert S. Scott
Canyon Sand & Gravel
P.O. Box 4362
Pagosa Springs, CO 81157
Phone Number_ [phone]
Fax Number: [phone]
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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 or Owner
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