2002-12-11_REPORT - M1977094

• Permit No: M1977094
• IBM Index Class Name: Report
• Doc Date: 12/11/2002
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

ANNUAL FEE and REPORT REQUEST
RECEIVED

PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
Morgan Sand and Gravel
M•1977-094
Westhoff Pit
December 20, 2002
$688.00 (Due on or before your anniversary date)
Morgan
Division of Minerals and Geology
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 [o 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 your revised written annual report and annual report map to 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: Gary Westhoff
Permittee Name: Morgan Sand and Gravel
Address: P.O. Box 1443
Ft Morgan, CO 80701
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.
or Designee
Date
2-
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M iPERMmh1ASTERDOC U M ENTSNI-AF-01