2001-06-15_REPORT - M1980020

• Permit No: M1980020
• IBM Index Class Name: Report
• Doc Date: 6/15/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

999
ANNUAL FEE and REPORT REOUEST
PERMITTEE NAME: ARS Sand & Gravel Co., LLC RECEIVED
PERMIT NO.: M-1980-020 JUN , 5 , ,
OPERATION NAME: Braley S&G Pit No 1
ANNIVERSARY DATE: July 15, 2001 Division of Minerals and Geology
ANNUAL FEE DUE: $688.00(Due on or before your anniversary date)
COUNTY: Douglas
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-I16, 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 annual report and annual report map to this form. Please note that an
adequately labeled rnap that clearly delineates and includes the above elements nlav suffice for a written
report.
Division records indicate the following petmittee contact information. Please verify and make any necessary
changes: 1
Permittee Contact: Chris Voethl JO4,.t CaTT!}ryt f� rFdl
Permittee Name: ARS Sand & Gravel Co., LLC
Address: 8505 W. Mtn. View Ln.
Littleton, CO 80125-000
Phone Number: [phone] 303 - -79 ) - _740
Fax Number: [phone] 3o 3 - -1 y 1 - -1 4 ° r
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.
Q .
Signature of Corporate Off or Owner
G - (0 - � 1
Date
M:XPERNI n VNASTER DOCU MENTSU7.AF-01