REP42108

• Permit No: M1983039
• IBM Index Class Name: Report
• Doc Date: 4/19/2004
• Doc Name: 2004 Annual Report
• From: Las Animas County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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RECEIVED
APR 19 2004
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Las Animas County
Division of Minerals & Gaolopy
M-1983-039
Airport Gravel Pit
Apri128, 2004
$688.00 (Due on or before your anniversary date) ~-$t 0700 ~7
Las Animas
According to C.R.S. 34-32.5-1 l6 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 your revised written annnal rennrt and annnal re~nrt map to this form- Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice jor a written
report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Phil Dorenkamp
Permittee Name: Las Animas County
Address: 2000 N. Linden Ave.
Trinidad, CO 81082
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~his form along with your written report and map. Annual Report instructions are
Owner,
M:~PERMI7IMASTERDOCUMENTS~'N-AF-04
Pa