2003-10-20_REPORT - M1981013

• Permit No: M1981013
• IBM Index Class Name: Report
• Doc Date: 10/20/2003
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

PERMITTEE NAME: Nichols Gravel Pit, L.L.P.
PERMIT NO.: M-1981-013
OPERATION NAME: Nichols Gravel Pit
ANNIVERSARY DATE: October 21, 2003
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ANNUAL FEE DUE: $688.00 (Due on or before your anniversary date)
COUNTY: Mesa
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-accompkished-to-datc-and-during-the-preceding-year,-new-disturbances-that~re-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 anmial re2nrt and anmlal rennrt maw in this form. Please note that 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: John Nichols
Permittee Name: Nichols Gravel Pit, L.L.P.
Address: P.O. Box 285
Mesa, CO 81643
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 t)'gis form along with your written report and map. Annual Report instructions are enclosed.
Signatur~f Corporate Officer, Owner, or Designee
Date
M iPERM ITNIASTERDOCUMENTSU.I-AF-01