2003-12-15_REPORT - M1984108

• Permit No: M1984108
• IBM Index Class Name: Report
• Doc Date: 12/15/2003
• Doc Name: Annual Fee/Report Notice
• From: Western Gravel Inc
• 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:
Western Gravel, Inc.
M-1484-108
Olathe Pit
December 14, 2003
DEC 1 52003
pivision of Minerals a~~~ ~-•
$281.00 (Due on or before your anniversary date)
Montrose
According [o C.R.S. 34-32.5-I 16 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator
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 your revised written anneal rennrt and anmial rennrt ma,~n to this form. Please 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 petmittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Judy DeVincentis
Permittee Name: Western Gravel, Inc.
Address: 3001 N. Townsend Ave.
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i?1mr/-/-roses Co. glKol
Montrose, CO 81401

Fax Number: [phone]
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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.
Owner, or Designee
Date
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M:IPERMITU1ASTER DOCUMENTSU-I-AF-01