2006-04-13_REPORT - M1994121

• Permit No: M1994121
• IBM Index Class Name: Report
• Doc Date: 4/13/2006
• Doc Name: Annual Fee/Report/Map
• From: Arthur Vasquez
• To: DMG
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNIVERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
~ ANNiiAi, FF.F, and RF.P/1RT RF.niTFST
,/ Arthur Vasquez
~/M-1994-121
Vasquez Quarry No 2
April 13, 2006
REDEI!/ED
APR 132006
~uision of Minerals and Raoloer
$281.00 (Due on or before your anniversary date)
Boulder
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-t 16, 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 far the year, if any.
Please attachynnr revised wriHen annual rennrf and anmral report maT 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 permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Beth Vasquez
Permittee Name: Arthur Vasquez
Address: P.O. Box 2526
Longmont, CO 80501
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.
r\ ~~/13t=L-
Signature of Corporate Officer, Owner, or Designee
yl~olo~
Date