REP46646

• Permit No: M1991133
• IBM Index Class Name: Report
• Doc Date: 4/17/2003
• Doc Name: Annuual Report
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

RECEIVED
APR 17 1003
Division of Minerals and Geology
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE
ANNUAL FEE DUE:
COUNTY:
Valle Escondido
M-1991-133
Valdez Gravel Mine
April 20, 2003
$688.00 (Due on or before your anniversary date)
Conejos
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 accomplished to date -arid during the p?eceding year, riew disturbances"tha[ 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 yonr revised written anneal report and anneal rennrt map to this form- P/ease note 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 information. Please verify and make any necessary
changes:
Permittee Contact: Demetrio Valdez
Permittee Name:
Address:
Phone Number:
Fax Number:
Valle Escondido
P.O. Box 84
Conejos, CO 81129
[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.
ignature of Corporate Officer, Owner, or Designee
Date /~~
M:NERM ITV.IASTERD000MENTSVv7-AF-01