2007-10-12_REPORT - M1978065

• Permit No: M1978065
• IBM Index Class Name: Report
• Doc Date: 10/12/2007
• Doc Name: Annual Fee/Report/Map
• From: Rio Grande County
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME;
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
ANNUAL FEE and REPORT REQUEST
Rio Grande County/~
M-1978-065 ~/
Seven Mile Plaza
October 22, 2007
RECEIVED /
OCT 12 2007 `~
Division of Reclamation,
Mining and Safety
$$323.00 (Due on or before your anniversary date)
Rio Grande
---According_to-C.R.S._34-32.5-116.or_C.R.S. 39_32-L16,_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 vour revised written annual report and annual report mao to this form. The Annual
Report & Fee requirement is not met until we have received the following components: fee, report, and
associated mau. If no new disturbances or reclamation have occurred during the previous year and no
new chances to the orevious year's mau are necessary. then no new map is required, provided that the
Operator shall state this in the Annual Report. Please note that an adequately labeled map that clearly
delineates and includes the above elements may su~cefor a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Patrick Sullivan
Permittee Name: Rio Grande County
Address: 168 N. Washington
Monte Vista, CO 81144
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 atta it to this form along with your written report and map. Annual Report instructions are
e osed.
~gnature of Corporate Officer, Owner, or Designee
/O G7GT d 7
Dale
M:~PERMI7IMASTERD000MENTS~M-AF-04