2007-07-16_REPORT - M2005077

• Permit No: M2005077
• IBM Index Class Name: Report
• Doc Date: 7/16/2007
• Doc Name: Annual Fee/Report/Map
• From: Upland Gravel, Inc.
• To: DRMS
• Permit Index Doc Type: Annual Fee / Report
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME:
PERMIT NO.:
OPERATION NAME:
ANNNERSARY DATE:
ANNUAL FEE DUE:
COUNTY:
iUpland Gravel, Inc.
~11I-2005-077
Upland Gravel Pit No. 3
July 5, 2007
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$$688.00 (Due on or before your anniversary date)
Mesa
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-te--a€fected -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 during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the yeaz, if any.
Please attach your revised written annual report and annual report map to this form. The Annual Report
& Fee requirement is not met until we have received the following components: fee, report, and associated
map. If no new disturbances or reclamation have occurred during the previous year and no new chances to
the nrevious year's mau are necessary. then no new map is required. provided that the Oaerator shall state
this in the Annual Renort. Please note that an adequately labeled map that clearly delineates and includes the
above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Gary Rinderle
Permittee Name:
Address:
Phone Number:
Fax Number:
Upland Gravel, Inc.
542 33 Rd.
P.O. Box 1380
Clifton, CO 81520
[phone]
[phone]
If you have additional comments and/or information that should be
below or attach it to this form along w' your written report and map.
ignature of Corpor~-/ate Officer, Owner, or Designee
~"~~/~~
Date-r~~
provided to the Division, please provide it
Annual Report instructions are enclosed.