2006-06-16_REPORT - M1981256

• Permit No: M1981256
• IBM Index Class Name: Report
• Doc Date: 6/16/2006
• Doc Name: Annual Fee/Report/Map
• From: Yuma County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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AN1VIiAi. FF.F, and RF.Pl7RT RF.QiiF.ST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
J Yuma Couuty
M-1981-256
Ekberg Pit
June 30, 2006
RECEI~I/ED
/ JUN 16 2U06
!~ Division of Minerals and GeoloBY
$688.00 (Due on or before your anniversary date)
Yuma
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 accomplishedto date and during the preceding year, new distuiliarices 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 ynnr revised written annual re~nrt and annual rppnrt maT 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: Paul Like
Permittee Name: Yuma County
Address: 1310 S. Blake St.
Wray, CO 80758
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.
~~.~~
Signature of Corporate Officer, Owner, or Designee
.~'~? - 06
Date
M:IPEAMI'nMASTERDOCUMEMS4M-AF-04