2006-02-14_REPORT - M1981236 ‎(2)‎

• Permit No: M1981236
• IBM Index Class Name: Report
• Doc Date: 2/14/2006
• Doc Name: Annual Fee/Report/Map
• From: Raymond C. Peterson
• To: DMG
• 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:
~. ANNiiAi. FF.F. and REPORT RF.niiF.ST
t/ Raymond C. Petersen
/ M-1981-236
Colorado River Ranch Gravel Pit
March 29, 2006
RECEIVED
~ FEB 14 2006
~hsion of Minerals antl Geology
$688.00 (Due on or before your anniversary date)
Grand
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,
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rcc~irmai:vii-8:ivcir tnc.-prccc°ding-~2?f~ -n@W-dtStirFbanee&-t11'r.~-~.va^,-..ti^-ipatC'~-t.^,--e.....::r
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 ~nnr reviced written anneal report and anneal re~7nrt m ~n 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: Raymond C. Petersen
Permittee Name: Raymond C. Petersen
Address: P.O. Box 832
ICremmling, CO 80459
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.
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LC
of
or Designee
Date