2001-06-28_REPORT - M1978162

• Permit No: M1978162
• IBM Index Class Name: Report
• Doc Date: 6/28/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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999
ANNUAL FEE and REPORT REQUEST
PERMI-.'TEE NAME: Morgan County RECEIVE®
PERMI NO.: M-1978-162 JUN 2 6 2001
OPERATION NAME: Harvey Green Pit Division of Minerals and Geology
ANNIVERSARY DATE: June 29,2001
ANNUAL FEE DUE: $550.00 (Due on or before your anniversary date)
COUNTY: Morgan
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 and during the preceding year, new disturbances that are anticipated to
occur d tring the upcoming year, reclamation that will be performed during the coming year, the dates for the
beginniltg 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.
Divisio t records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Joe B. Baltazar we, w. L1 /1&'7 2ner_4,i.
Permitt,ee Name: Morgan County ® �- e:,N
Address: 17303 CR S XP�,o,,,.,.oe,
Ft Morgan, CO 80701
Phone Number: [phone]
Fax Number: [phone]
If you nave 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.
X/96d�—_ 3
i ah,Ire of Corporate Offi r or Owner
Date
M.NERMI RMASTERDOCUMENTSW-AF-Oa