2001-11-26_REPORT - M1977387

• Permit No: M1977387
• IBM Index Class Name: Report
• Doc Date: 11/26/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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999
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Prowers County
M-1977-387
Bates Pit
December 1, 2001
RECEIVED
NOV 2 6 2001
Divisional Minerals and Ceolopy
$688.00 (Due on or before your anniversary date)
Prowers

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 [o 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 maa to this form. Please note rhnt 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. Tony Garcia
Permittee Name: Prowers County
Address: 301 S. Main, Ste. 215
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l oq E. 5~~~,,.a.. st
Lamar, CO 8 ] 052 ~ma r, P ~ Sf/OS2
Phone Number: [phone] l 7/q~ S37 ~ L~i 3 ~-7
Fax Number: (7]9)537-6357 ~ZIR,~ J~Z-~i~sl
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 orporate Officer or Owner
Dale
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