REP46255

• Permit No: M1977425
• IBM Index Class Name: Report
• Doc Date: 3/18/2004
• Doc Name: Annual Fee/Report Notice
• From: Larimer County
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

~.s e
PERMTTTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Larimer County
M-1977-425
Strang Gravel Pit
Apri123, 2004
$688.00 (Due on or before your anniversary date)
Larimer
~/- a,~
RECEIVED
MAR ~ 8 2004
plvlsion of Minerals & 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
._ tiperator shall submtt the annual-fee, a"report and map sF~owing 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 yeaz, reclamation that will be performed daring the coming year, the dates for the
beginning of active operations, and the date active operations ceased for the yeaz, if any.
Please attach ynnr revised written annnal report and annual rennrt man to this form- Please nofe 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 informafion. Please verify and make any necessary
changes:
Permittee Contact: Dennis C. Morrison
Permittee Name:
Address:
Phone Number:
Fax Number:
Larimer County
P.O. Box 1190
Fort Collins, CO 80522
[phone]
[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.
C
Signa ure of Corporate Officer, Owner, or Designee
~~~by
Date ~ ~
M:~PERMITMASTER17000MENTS~M-AF-04